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Tag Archives: HIV and Right to Employment

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

The-Number-Of-People-Living-With-HIVAIDS-In-Akwa-Ibom-Will-Shock-You-»-Naijaloaded

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

mrx

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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Suit to challenge termination of employment on account on HIV status: Activists and PLHIV identify with Lawyers Alert

The suit challenging the termination of Mr X by his employers on account of his HIV status came up a fortnight ago  at the National Industrial Court in Abuja, and Activists including PLHIV were at hand to identify with the cause.  Persons from NEPWAN, APYIN, SOWCHAN, AHF, NINERELLA+, Heartland Alliance and ASHWAN flooded the court in show of solidarity. This followed advocacy efforts by Lawyers Alert in partnership with Enda Sante. The case of Mr. X, is lodged at the National Industrial Court Abuja by Lawyers Alert in partnership with Southern Africa Litigation Centre (SALC).

“PLHIV have the Right to Employment” adorned T-Shirts was everywhere at the Court premises. Mr X lawyers, Bamidele Jacobs and Sunday Adaji  of Lawyers Alert, were ready and prepared to proceed with the matter which was slated for hearing. The Defendants however sought adjournment to adequately prepare owing to late service of vital documents. The judge granted their request for time to prepare their response and fixed the case to 31st of October 2017 as the next hearing date.

 

Bamidele Jacobs Esq, speaking to Activists after the case.

Sighting the number of people in the court room with their T-shirts on, the Judge opined that probably at the next adjournment, hearing maybe in Chambers and advised supporters in solidarity to be within the court premises and not in the courtroom.

After the hearing, Activists converged in Lawyers Alert office, where Yemi Agoro gave a welcome speech and deliver the greetings  while  Bar. Bamidele gave the history of the case,  and update of what actually transpired in the court room.

Amber Erinmwinhe of NINERELLA+ spoke on behalf of the organizations and Activists present to appreciate the effort of Lawyers Alert in getting justice for the PLHIV community in the country and pledge  continuous support anytime the need arise.

 

 

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