HIV, as we know it, is a virus that damages the immune system and makes you more susceptible to other diseases. If left untreated, HIV can deteriorate to stage 3, an advanced stage known as AIDS.
A population that is mostly ignored in HIV/AIDS research and treatment is the transgender community. This is caused by stigmatisation, discrimination, economic vulnerability, etc.
However, before going further in this article, what makes up the transgender population?
Transgender is an umbrella word for persons whose gender identity is different from their assigned sex at birth.
Transgender is commonly abbreviated and known as trans.
For example, a transgender man was born with female sex organs but now identifies as male. On the other hand, a trans woman is an adult who was born male but now identifies as a female.
The majority of transgender people choose surgery or hormonal transition, or both, to change their appearance and match their gender identification.
What does the transgender population have to do with HIV/AIDS?
- In previous research, transgender persons are counted according to their biological sex, ignoring their identities and making them invisible to public health professionals and advocacy groups like NHVMAS working on HIV prevention, treatment, and care.
- Transgender persons suffer a higher incidence of bias in the health world. Examples of such bias are; doctors who don’t know how to care for transgender persons, refuse to treat them or abuse them. It also includes non-transgender-inclusive health insurance coverage that might put people at risk of contracting HIV.
- Due to social bias, especially in a country like Nigeria, transgender persons may experience higher unemployment, housing discrimination, and poverty, making testing and treatment more difficult to come by and afford. When that happens, they will not be able to know their HIV status and will fail to take the essential steps to prevent the virus from spreading to others.
- As I mentioned earlier, some transgender persons may choose injectable hormonal transitions to change their appearance to match their gender identification. However, due to the possibility of sharing needles or using dirty needles, transgender persons may be exposed to HIV transmission.
How do we prevent the spread of HIV/AIDS among the transgender population?
- If you’re transitioning using injectable hormonal medicines, make sure you use a fresh needle for each injection and don’t share needles.
- The danger of HIV transmission is reduced by limiting the number of sexual partners. This applies to both cisgender and transgender persons.
- The use of condoms greatly reduces the spread or transmission of HIV/AIDS. Taking PrEP before sexual contact can also reduce the risk of contracting HIV.
- Visit any credible hospital in your area to be tested, or reach out to us on Facebook, Instagram, or Twitter.
Visit the NHVMAS website if you’d like to learn more about what we do or how you can help stop HIV/AIDS from spreading in Nigeria. The change begins with you and me.
– Oluwaremilekun Adenike, 2022 LeNNiB Champion
Twice a week, I make this long journey from Ijegun to Ojodu Berger. If you are familiar with Lagos state, you will agree with me when I say that it’s not an easy feat.
On those days, the dash to get out of the house so that I can make it to class on time can be exhilarating, but I am not complaining.
In fact, I eagerly anticipate it.
It has broadened my knowledge of HIV prevention advocacy and all the work that goes into planning strategic and effective HIV prevention programs for various demographics.
From Mr. David (our very own prof, calmly dropping nuggets of wisdom and a continual reminder of the no lateness rule), to Mr. Tosin (our plagiarism catcher, always cool and calm, patiently listening to our countless arguments), then Mr. Richard (proper M & E, he is all about the numbers), Ms. Florita (ever-smiling, you can literally feel her passion every time she teaches and it is so infectious) and the lovely Ms. Olayide (so eloquent, I could listen to her speak all day), our coordinators and facilitators have been amazing.
My favorite part of the program has to be my fellow champions. I love how the class can be serious one minute and burst into a series of hot takes the very next. The conversations and the respectful differences in opinions are what I look forward to the most.
I would also like to not forget our yummy free lunches and wifi.
I feel lucky to be a part of this program, and I am excitedly looking forward to the next 5 months as a LeNNiB champion.
-Queen Uguoeru – 2022 LENNiB Champion
Juliana, a female sex worker at Miliki brothel, got pregnant by one of her customers, but unfortunately, the man denied the pregnancy. She tried to abort the baby but all the efforts proved abortive, hence a sign that she should probably keep the baby which she succumbed to. Juliana decided to give birth traditionally because of the exorbitant hospital bills. During child birth, there was a little complication which mandated the need for her transfer to a general hospital where they found out the baby was HIV positive. The doctors tested the mother immediately and the same result was observed.
Juliana was enrolled with her child and they both were placed on treatment.
Had Juliana’s status been known to her, she could have been enrolled for PMTCT-Preventing and eliminating mother to child transmission of HIV.
PMTCT of HIV refers to the spread of HIV from an HIV positive woman to her child either during pregnancy, child birth, or breastfeeding.
Components of comprehensive PMTCT.
- Primary prevention of HIV infection among woman of child bearing.
- Preventing unintended pregnancies among woman living with HIV.
- Preventing HIV transmission from a woman living with HIV to her infant.
- Providing appropriate treatment, care and support to mother’s living with HIV and their children.
Ogunyemi Opeyemi – 2022 LeNNiB Champion
Modern science has wrought great wonders in HIV prevention and treatment. It is no doubt that for those who are equipped with full and correct information, preventing infections by the virus through PrEP is one of the most reliable and far reaching methods, providing up to 99% protection if used correctly and consistently.
The most common regimen for PrEP is the Daily PrEP which basically involves popping one pill daily, everyday. But the problem with this method is that, not everyone can bear taking daily pills, they might not like medications well enough to take one pill daily; or they might not even have sex enough times to justify the daily intake of the drug. This is where a different regimen of PrEP intake can function effectively — Event Based PrEP (EBP).
Event Based PrEP (EBP), also called On-Demand PrEP is a type of regimen that is purposed for people who have planned sex. It is important that the sex commencement is planned for a particular time period and not spontaneous, as that is the only way this would work. Because of the manner of taking this regimen, it is sometimes called 2-1-1.
The manner of EBP intake is as follows:
- Take two start-up pills 2-24 hours before the sex. This means that if I for instance have sex planned for 3pm tomorrow, I should take the two pills between the periods of 4pm today and 1pm tomorrow. At least two hours must be left between the time the start-up pills were taken and the sex. If for any reason the two pills cannot be taken at once, they can be taken singly, but both must within the stated time period.
- Take one pill 24 hours after the first dose as a follow-up dose. This second dose should fall around the same time the two start-up pills were taken the previous day.
- Continue taking one pill around the same time as the start-up pills until the second day after the sex.
Event Based PrEP according to studies has been found to provide just as much protection as regular daily PrEP if adhered to strictly. Now, this is where the problem lies — remembering to take the pills at the time one is supposed to.
Ogunyemi Opeyemi – 2022 LeNNiB Champion
Pre-Exposure Prophylaxis (PREP) has been globally lauded as one of the most potent biomedical interventions introduced in the 21st century to combat the HIV/AIDS pandemic. Indeed, according to World Health Organization, in 2020, there were about 940,000 people across 83 countries in the world who received oral PREP at least once in 2020. Most PREP users in 202o were reported in the African (52%) and Americas (30%) regions.
However, one of the major complaints that has resonated in respect of oral PREP is its daily intake. Many individuals are generally adverse to medications-particularly reoccurring ones-and thus this has caused a big issue in medication adherence. In this light, a long-acting injectable PREP-which is administered once every two months- is especially welcoming. In addition, various clinical trials have revealed that long-acting injectable PREP offers superior efficacy (66% -89%) to oral PREP. Not to be overlooked is also the fact that with this new form of HIV Prevention, medications do not need to be carrying medications everywhere which makes it more convenient to travel and also engage in sexual adventures.
This innovation is not without its detriments. For one, it would mean more trips to the health center (6 times a year) as opposed to the trimonthly approach of oral PREP. This is because only qualified health practitioner can administer the injections. In addition, the medication is dangerously overpriced. In the United States of America, a single PREP injection costs about $3,700, which in Nigerian naira, amounts to N1,537,905.00 using official bank rates. This is far above the financial capacity of residents of both countries and indeed, across the globe. Thus, its availability and affordability is very limited.
Nevertheless, an overall appraisal shows that the benefits of long-acting injectable PREP far outweigh its cons. It is extolled as a medical breakthrough, one capable of bringing humanity one step closer towards eradicating the HIV/AIDS pandemic. It is hoped that with time, injectable PREP would be engaged globally at an affordable price.
Opeyemi Ogunyemi – 2022 LeNNiB Champion