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Tag Archives: HIV and AIDS in relation to Human Rights.

SIGNIFICANCE OF THE UNDETECTABLE EQUALS UNTRANSMITTIBLE (U = U) CONCEPT/CAMPAIGN ON THE LIVES OF PEOPLE LIVING WITH HIV

 by: VICTOR EBOH ESQ                                                                                            (LEGAL/REPRODUCTIVE RIGHT OFFICER) LAWYERS ALERT

LAWYERS ALERT

1st day of December of every year is designated as WORLD AIDS DAY, an international day dedicated to raising awareness of the Aids pandemic caused by the spread of HIV infection and mourning those who have died of the disease.

 

There is no known cure for HIV/AIDS in the world today. However, treatment for

HIV, offers hope for people living with the virus. According to the UNAIDS Fact Sheet (2019), there are 37.9 million people living with HIV, globally.

Out of this number, 24.5 million people are accessing HIV treatment.

 

In Nigeria, UNAIDS (2018) estimated that 1.9 million people in Nigeria were living with HIV, however, in 2019 statistics indicate a 1.4% HIV prevalence rate among adults aged 15-49 years in Nigeria. Consistent and effective HIV treatment leads to improved health outcomes for people living with HIV.

Scientific evidence holds that people living with HIV who have an undetectable viral load cannot transmit HIV via unprotected sex to their partners. This is the basis for the undetectable equals untransmittable (U=U) concept.

 

CONCEPT OF UNTRANSMITTABLE (U = U)

 

The U=U Campaign was started by PREVENTION ACCESS, an organization in

the United States which seeks to raise awareness and ensure universal access to

treatment for people living with HIV. It is beneficial for people who are diagnosed

with HIV to start treatment early and adhere, by remaining on treatment. This

reduces the amount of HIV in the blood stream to an undetectable level. In simpler

terms, an undetectable HIV viral load means that the amount of HIV in the blood is

negligible.

 

The Centre for Disease Control, CDC (2019) holds that most people on

HIV treatment achieve an undetectable viral load within six (6) months of initiating

HIV treatment. This occurs as long as they consistently take the medication as

prescribed. After, the initial six (6) month period, adherence to HIV treatment is

advised to ensure that the HIV viral load stays undetectable. While the CDC (2019)

defines an undetectable viral load as having less than 200 copies of HIV per mililitre

of blood, the Canada AIDS Treatment Information Exchange, CATIE (2018) notes

that, HIV viral load is undetectable when it is less than 40 to 50 copies of HIV per

mililitre of blood.

 

The U=U concept is supported around the world by renowned organizations. The

World Health Organization, WHO (2019) cites an empirical study to the effect that,

the risk of HIV transmission through sex, where condoms are not used, in sero-discordant couples is effectively zero when HIV viral load is suppressed through

ART treatment. The WHO recommendation to initiate ART in all people living with HIV will contribute significantly to reducing HIV transmission.

 

From the foregoing, there is no risk of HIV transmission through unprotected sexual

intercourse from a person living with HIV to a negative partner as long as the former

is on HIV treatment and has achieved an undetectable viral load. This finding has far

reaching implications on the relationships and interactions between people living

with HIV and those who are HIV negative, especially surrounding stigma and

discrimination.

 

People living with HIV often suffer stigma from other members of the public when they know the HIV status of the former. Thus, scientific evidence such as U=U which supports the fact that people living with HIV who consistently adhere to HIV treatment, and become undetectable, cannot transmit HIV through unprotected sex, “strikes down” the reason for the stigma and discrimination against people living with HIV.

In addition, UNAIDS (2018) lends credence to the U=U concept with its submission

that, there is a strong scientific consensus that people living with HIV who are taking effective antiretroviral therapy and whose level of HIV is suppressed to undetectable levels, will not transmit HIV sexually.

 

This evidence from UNAIDS (2018) is borne from twenty (20) years of research

which demonstrates that effective treatment of HIV reduces the risk of HIV

transmission. Due to this fact, the U=U concept validates previous concepts such as

Treatment as Prevention (TasP). The reasoning is logical. If HIV treatment reduces

the risk of HIV transmission, then it simply means that HIV treatment is an effective

strategy at preventing the transmission of HIV from one person to another. However,

it is important to reiterate the conditions necessary for which transmission of HIV

will not occur. The person living with HIV, has to adhere to HIV treatment and consistently maintain an undetectable HIV viral load.

In Nigeria, (and indeed most countries of the world) HIV treatment services are free and viral load tests are conducted once every six (6) months. There is a persistent need to ensure that user fees are not charged to encourage access and uptake of HIV treatment.

Strict adherence to HIV treatment is advised for people living with the virus. This is

necessary because consistent HIV treatment ensures that the virus remains

undetectable over a long period and reduces the risk of transmission via unprotected

sex to zero (0). Thus, people with effective HIV treatment cannot transmit the

virus  through unprotected sex. This has far reaching implications on public health

and should re-configure popular perception about HIV especially the way people

living with HIV are treated in society.

 

Evidence for further validation of the U=U concept is provided by findings from

other empirical studies. Three (3) large studies (undertaken between 2007 and 2016)

were cited by Cohen, Chen, McCauley et al (2011), Roger, Cambiano, Bruun et al

(2016), and Grulich et al (2015). In each of these studies, the researchers investigated

sexual transmission of HIV among thousands of couples. With each of these couples,

one partner was living with HIV and the other was not, i.e. sero-discordant.

Findings from these studies show that there was not a single case of HIV transmission from the partner living with HIV (who had achieved undetectable levels of HIV) to their HIV negative partner. (Source: Rural Renewal & community Health Development Initiative)

 

Conversations as well as public enlightenment about the U=U concept are necessary

In the society to combat the stigma and discrimination which people living with HIV

face, especially regarding inter-personal relationships, family and even in the work

place. With the empirical evidence presented on U=U, people living with HIV

should not be barred from marriages and romantic relationships with others who are

HIV negative. They pose no risk because they cannot transmit the HIV virus through

unprotected sex. Sero-discordant couples have the potential of raising children

without the risk of transmitting HIV. Also, marital disharmony owing to HIV

diagnosis of one partner should not arise.

 

CONCLUSION

 

The concept of U=U offers hope to people living with HIV because HIV treatment

affords dignity, inclusion and acceptance in society. With effective public

enlightenment via relevant communication channels, notions of HIV/AIDS as a

deadly epidemic can be replaced with the U=U concept which demonstrates how

HIV transmission can be stopped. The hope and benefits from maintaining

undetectable levels of HIV will encourage people living with HIV to access HIV treatment services because it is a means to an end. Families, relatives and partners will be more accepting and supportive to persons living with HIV because they are no longer threatened by HIV transmission and treatment holds greater promise for better health outcomes.

Furthermore, countries and legal systems which impose travel bans as well as

criminalize people living with HIV on account of disclosure and so called “intended

HIV transmission,” need to revise these laws via necessary steps in the judicial

process. The scientific evidence from existing research is sufficient basis for judicial

reform in this respect. Also, the police, vigilante and other security agencies require

education and enlightenment on the U=U concept in order to guide the

administration of justice when complaints and disputes regarding HIV transmission

are brought before them.

References:

1. Three (3) large studies (undertaken between 2007 and 2016)

were cited by Cohen, Chen, McCauley et al (2011), Roger, Cambiano, Bruun et al

(2016), and Grulich et al (2015)

2. UNAIDS (2018) is borne from twenty (20) years of research

which demonstrates that effective treatment of HIV reduces the risk of HIV

transmission.

3. The World Health Organization, WHO (2019)

4. Canada AIDS Treatment Information Exchange, CATIE (2018)

5.  The Centre for Disease Control, CDC (2019)

CAVEAT

Lawyers Alert hereby puts our readers on notice that this article is based on the writers opinion and do not necessarily represent the views of the organization except otherwise stated.

 

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The User Fee Charge and Its Implication on Persons Living with HIV and AIDS

By Blessing Mase

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According to a “U.S –Supported Nigeria HIV/AIDS Indicator and Impact Survey,” about 1.9 million people are still living with the virus and 80% of them are living below poverty line. As a result of this, they find it difficult to access HIV treatment due to the fact that they are being asked to pay what is called the ‘User Fee.‘

Now, what is user fee charge? User fee charge is seen as money paid to access services in health care center.

Facts about User Fee Charge

Research has been carried out concerning user fee charge which has been a burden to PLWHIV (persons living with HIV and AIDS) and it was discovered that a lot of people pay user fee in other to access the ARV drugs which has and is causing a lot of pain to them as a result of the state of poverty they are in.

Over the years, donors like PERFAR (Presidency Emergency Plan for AIDS Relief)  have been the ones sponsoring these ARV drugs but since there was lack of fund to continue with the funding, PLWHIV are been asked to pay this fee. The fee includes opening of files which cost N200, consultation to see a doctor in which series of test is administered to them like viral load test, CD4 test, Eye test, Liver test. As a result of the multiple test that has to be carried out in other for them to access these drugs, it becomes so difficult for them to pay for the test which will go for as far as N4,000-N5,000, considering the fact that most of these PLWHIA cannot afford three square meal or  even a meal or two  a day. According to Claire Pierangelo, a US Diplomat, such fee constitutes a major barrier to people living with HIV/AIDS.

Another test that got my attention was the “Genotypic Resistant Test.” This test is an antiretroviral resistance test that is used to help select drugs regime that will likely be effective in treating a person with HIV infection The test go as far as N35,000 while other hospitals collect N60,000-N65,000. As a result of these huge amounts placed on this test, it was reported that three persons who could not pay for the test in other to access the drugs died at Nyanya General Hospital.

It has gotten to a point where some doctors now write proposals without the knowledge of the management in other to source for fund to help pay for these test in other not to stain their reputation. It is a way to help save lives of these persons living with the virus. Some of them are orphans, unemployed youths and parents who can’t afford the money.

Way Forward

The government needs to ensure that the user fee imposed of PLWHIA is removed. The Government should ensure that the 1% budget that is allocated to health sector for ARV drugs is implemented.

The United States Consular General, Claire Pierangelo has advised that an increase in the funding of antiretroviral drugs would enable these people to leave healthy, productive lives until the day a cure is found.

Reference: https://www.premiumtimesng.com/health/health-news/360312-u-s-diplomat-wants-user-fees-for-people-living-with-hiv-removed.html

CAVEAT

Lawyers Alert hereby puts our readers on notice that this article is based on the writers opinion and do not necessarily represent the views of the organization.

 

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Mr. X Terminated On Grounds Of His Hiv Status Gets The Fruit Of His Victory

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Dear Colleagues and folks,

Recall the National Industrial Court of Nigeria’s Judgement prohibiting employers from coercing existing or prospective employees to undergo HIV testing and that dismissing employees on the basis of their perceived or actual HIV-status is unlawful and discriminatory. Recall also the court awarded monetary damages to the total sum of 4,200,000NGN (11,500USD). This followed a suit by Mr. X. who was dismissed on account of his HIV status. Lawyers Alert filed and prosecuted the matter on his behalf. The judgement can be found here.

Lawyers Alert alongside Mr. X met severally with the employers and their lawyers towards negotiating an agreed judgement sum so as to bar an appeal alongside the expected time the appeal would have been disposed of. An appeal can take several years.

Lawyers Alert is happy to announce that last week, we received an inflow for the judgement sum negotiated at 3,000,000NGN (8,400USD) on behalf of Mr. X. Mr. X. was in our office on Saturday 30th March 2019 to receive from Lawyers Alert a cheque in the total sum of 3,000,000NGN representing the entire judgement sum as paid.

Lawyers Alert acknowledges with deep appreciation Southern Africa Litigation Centre (SALC), and everyone that contributed in one way or another towards justice for Mr. X. and the judgement which prohibits employers from coercing existing or prospective employees to undergo HIV testing and that dismissing employees on the basis of their perceived or actual HIV-status is unlawful and discriminatory.

We acknowledge Southern Africa Litigation Centre (SALC), Enda Sante, Joint United Nations Programme on HIV/AIDS (UNAIDS) Nigeria, AIDS Health Foundation (AHF), National Agency for the Control of AIDS, United Nations Development Programme, International Labour Organization (ILO), Coalition of Lawyers for Human Rights (COLaHR), Network of Persons Living With HIV/AIDS in Nigeria (NEPWHAN), Nigeria Network of Religious Leaders Living with or Personally Affected by HIV/AIDS (NINERELA+), Association of Positive youth living with HIV/AIDS in Nigeria (APYIN), Society of Women and Children Living With HIV/AIDS in Nigeria (SOWCHAN), Association of Women Living With HIV/AIDS (ASWHAN) in Nigeria and other Human Rights Activists.

A picture of Mr. X. collecting his cheque can be found here and a video of his experience can be found here.

Thank you.

 

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Employers of labour must comply with HIV/AIDS non discrimination Act

HIV-AIDS.jpg

A Civil Society Organisation in Nigeria, Lawyers Alert has insisted that employers of labour in the public and private sector must comply with the HIV/AIDS non discrimination Act to protect workers who that are infected with Acquired immunodeficiency syndrome (AIDS), a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV).

The President of Lawyers Alert, Mr Rommy Mom told Daily Trust that the HIV/AIDS non discrimination Act that was passed into law in Nigeria five years ago was not implemented and that his organization has dragged the Minister of Justice and Attorney General of the Federation, Abubakar Malami to court to demand full implementation and total adherence to the law.

He said the HIV/AIDS non discrimination Act mandates the Attorney General of the Federation to ensure that work places have HIV/AIDS policies to protect workers that are HIV positive.

He said the law was passed in 2014 and that it mandates the AGF to ensure that employers of labour in public and private sector in Nigeria have the policy within three months.

Mr Rommy expressed concern that the law was not implemented five years after and that no policy in work places to protect people living with HIV.

He lamented that majority of workers that are HIV positive are facing all forms of discrimination and stigmatization in their places of work.

 

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COURTESY VISIT BY THE HOPE SISTERS AGAINST HIV/AIDS, STIGMA AND DISCRIMINATION INITIATIVE

On the 29th day of August, 2018, the Hope Sisters Against HIV/AIDS, Stigma and Discrimination Initiative, a Women-Led Grassroot Civic Group in Makurdi, Benue State paid a Courtesy Visit to Lawyers Alert Head Office in order to identify with the LA and strengthen the existing working relationship between both Organizations.

 

The group was led Miss. Maria Okwoli, the Executive Director, she was received by Mr. Lazarus M. Ahangba, the Programs Manager of the Head Office. In her address, Miss. Okwoli prays LA for their assistance and support to the members of their group since the partnership started a few months ago. She said the visit was necessary owing to changes within the Organization especially at the leadership level. As a key partner and stakeholder to the Organization it becomes pertinent to formally visit and intimate the Organization of the changes that had occurred within the period. She went ahead to create the indulgence of LA to continue with the support it has always given to the group even with this new leadership that they look forward to a harmonious relationship with LA going forward.

In response, Mr. Lazarus, thanked the group for their visit and expressed delight over the group commitment to course of Women Human Rights especially those of the most vulnerable which they represent. He promised LA will continue to work and partner with the group particularly in areas of mutual interests. Furthermore, he told the group that the offer to build the capacity of its members on Monitoring/Documentation of Human Rights Violations, Gender Based Violence and Sexual and Reproductive Health Rights is still open and they can liaise with the appropriate officers in charge of those areas.

In addition, R.A. Hwande Esq, mentioned the efforts of LA in providing pro bono services to vulnerable women and how they can also explore same. He went ahead to give examples of past and recent incidences LA had offered pro bono to some members of their group in conflict with the law.

After this, the meeting came to an end with a vote of thanks by Miss. Okwoli. She thanked LA for finding time to host them and look forward to a better working relationship. Shortly after this, a group photograph was taken.

 

 
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Posted by on August 31, 2018 in HIV/AIDS & HUMAN RIGHTS

 

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HIV and AIDS, Ethics, Human Rights and the Law

Lawyers’ Alert work in HIV and AIDS is restricted to principally two thematic areas, Human Rights Education and Rights Enforcement through litigation/Advocacy. Secondly massive education and capacity building on Preventing Mother To Child Transmission, PMTC.  We believe successfully preventing and eliminating Mother to Child Transmission will be a key step in wiping out new infections and ultimately end AIDS.

Our involvement began in 2003, when Lawyers Alert organised a workshop in Benue State on HIV and AIDS in relation to Human Rights. The theme of the workshop was “HIV and AIDS, Ethics, Human Rights and the Law”. The workshop was for Persons living with HIV and AIDS, NGO’s and Policy makers with the support of the British Council. The workshop sought to explore positive living against the backdrop of the law and human rights in Nigeria, using Benue State as a case study.

 

Following the workshop it was established by participants that there indeed exist a lot of human rights violations by the state and non state actors in principally the rights to health, education and employment with regard to especially women and children.

 

Following this cardinal finding by participants, in 2004, Lawyers Alert carried out a situation analysis on HIV and the Law in Benue wherein we published  booklet titled “HIV and AIDS: A Legal Framework” where we explored the relationship between Human Rights and the treatment of persons living with AIDS.   This book is the product of engagement with the community of persons living positively and legal institutions. It became crystal clear that while Government has beautiful and well laid out plans in States Strategies, political will often do not match the strategy papers.

Owing to frustrations of non implementation of strategy documents, Lawyers Alert alongside the Community of person+ explored the idea of creation of obligations on the state and private hospitals, schools and industries with regard to women and children so this can be enforced.  Only a law can achieve this, and this has been the struggle since 2005, to have a Non Discrimination Law passed by the State that will regulate and create obligations on routine testing of pregnant mothers, early infant diagnosis, adequate Medicare for mothers and children living with AIDS, access to education and non discrimination at workplaces, etc.

Legislation in these areas will go a long way in preventing mother to Child transmission, eliminate discrimination, enhance access to education, and guarantee employment for women.

Lawyers Alert has continuously partnered the then State Action Committee on AIDS on issues bothering on human rights and the law regarding HIV and AIDS. We specifically drafted the Bill transforming the State Committee to an Agency so as to make it more effective. The Bill has since been passed into law. Over the years we have effectively participated in the drafting of State strategic Plans for the Agency inclusive of other activities.

Lawyers Alert has represented over 100 person+ in efforts at enforcing or protecting their rights to accommodations, uninformed testing, workplace discriminations etc. We have carried out over 12 workshops, in building capacity and creating awareness on rights of person+ in Benue, Nassarawa and Plateau States.

Regarding PMTC, we are involved in mass community education in changing values especially with regard to Gender. Gender empowerment and elimination of stigma is key to effective PMTC. When the rights of women are respected by elimination of violence, disinheritance, access to education created and jobs provided, with fewer stigmas and discrimination, PMTC will succeed.

We have carried out efforts in these regard through awareness creation/capacity building and community theatre in especially between 2008 to date.

All Lawyers Alert programs have the above main streamed into it.

Lawyers Alert is presently in the process of developing tools to measure the impact of our work in Benue, Nassarawa and Plateau States in the sphere of HIV and AIDs/ Human Rights.

 

 
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Posted by on August 28, 2012 in HIV/AIDS & HUMAN RIGHTS

 

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