The Impact of National Strategies of HIV/AIDS Among Women in South-West Nigeria

This study aims to investigate the effect of national strategies in tackling HIV/AIDS among women in South-West Nigeria. It explores the prevalence of HIV/AIDS, social determinants, health and socioeconomic implications, and the effectiveness of national strategies. The study uses secondary data and follows a principle-based approach to ethical considerations.

THE IMPACT OF
NATIONAL STRATEGIES
OF HIV/AIDS AMONG
WOMEN IN SOUTH-WEST
NIGERIA

Table of Contents
INTRODUCTION ...............................................................................................3
BACKGROUND AND RATIONALE.......................................................................3
AIMS AND OBJECTIVES ....................................................................................5
METHODOLOGY................................................................................................5
LITERATURE SEARCH STRATEGY......................................................................7
PROJECT OUTLINE............................................................................................9
REFLECTION ..................................................................................................10
References.....................................................................................................10

RESEARCH STATEMENT / QUESTIONS
What is the effect of national strategies (2010- To present) in tackling HIV/Aids among women
in the South- West of Nigeria.
INTRODUCTION
The HIV is referred as Human Immunodeficiency Virus; it is the microorganism which
destroy and attack the contagion beside this it also affliction immune system and CD4 T cells
which assist the body to fight against them. If a suffered person is not take treatment then they
demolish the immune system and lead to AIDS. Acquired immunodeficiency syndrome (AIDS)
is a chronic and severe, life threatening condition caused by HIV. It damage body and unable to
fight against organism, it is sexually transmitted infection which is caused by HIV virus as well
as can be reason of death. it has also provide other pestiferous of worldwide involvement. (The
World Health Report, 2003).
BACKGROUND AND RATIONALE
Nigeria has the second largest HIV transition in the world. HIV prevalence among adults
is much less (1.5%) than other sub-Saharan African countries such as South Africa (20.4%) and
Zambia (11.3%), the size of Nigeria's population means 1.9 million people were living with HIV
in 2018. However, UNAIDS estimates that around two-thirds of new HIV infections in West and
Central Africa in 2017 occur in Nigeria. This is despite achieving a 5% reduction in new
infections between 2010 and 2017.
The National Strategic Plan is “An AIDS-free Nigeria, with zero new infection, zero
AIDS related discrimination and stigma” Goal of the National Strategic Plan. The goal of the
National Strategic Plan is to “Fast-track the national response towards ending AIDS in Nigeria
by 2030” Thematic Areas and Cross-Cutting Issues The National Strategic Plan has five thematic
areas: Prevention of HIV among General and Key Populations, HIV Testing Services,
Elimination of Mother-to-Child transmission of HIV (e MTCT), HIV Treatment; and, Care,
Support and Adherence (National Agency for Control of Aids, 2017)
According to Fagbamigbe, Adebayo and Idemudia (2016). It show that Nigeria the case
of HIV as increase by 1.8% to 4.5% to 5.8% in 1991, 1996, and 2001, respectively, a decline was

observed as 5.0% in 2003 and 4.4% in 2005. Also, 2008 and 2010 surveys show HIV prevalence
of 4.6%12 and 4.1%, several. However, a general population survey carried out in 2007 put HIV
prevalence at 3.6%, higher among females (4.0%) than males (3.2%). The latest national surveys
in 2012 showed a lower general population HIV prevalence of 3.4% in Nigeria, ranging from
3.2% to 3.6%. The 2010 national survey of MARPs reported that HIV prevalence of 27.4%
among brothel-based female sex workers, 21.1% among non-brothel-based female sex workers,
17.2% among men who have sex with men, and 4.2% among injecting drug users. (Fagbamigbe,
Adebayo and Idemudia, 2016).
Unequal gender nexus have a significant influence on men’s and women’s differentiated
risks to HIV infection, as well as their access to prevention, treatment, care and support. Gender
inequalities increase women’s exposure to infection, through their lower status and lower access
to education. The 2008 DHS showed a positive correlation between women’s participation in
household decision making and their access to health services (Samuels, Blake and Akinrimisi.
2012).
According to Odimegwu, Alabi, Wet and Akinyemi, (2018) confirms that HIV/AIDS is
more among women in southwestern Nigeria. HIV/AIDS in Nigeria is increasing among women
than men. (Samuelsen, Norgaard and Ostergaard, 2012). The difference in the prevalence of HIV
between women and men is more obvious among younger adults, with adolescent women
between ages 20 and 24 years more than thrice as likely to be carrier of HIV as male of same age
group. (UNNAIDS, 2014).
The spread of HIV in the last 3 decades has greatly affected health, welfare, employment
and criminal justice sectors; having negative impact on every social phase of human. Recent
epidemiological survey reveals that HIV is still a serious health issue that has continuously
drains our national, regional and state finance having claimed over 25 million lives over the last
3 decades. (Awofala and Ogundele, 2016).
According to Ogunbodede, (2004) major socioeconomic factors determining the spread
of HIV/AIDS in South West Nigeria has decline in social services, impoverishment, subordinate
position of women, modernization, rapid urbanization, wars and conflicts.
Analysis has revealed that despite that intervention, new infections rose from 11,230 in
2012 to 116,780 in 2013 with 112,239 PLHWAs (2012) and 115,578 (2013). As of 2012, the
number eligible for ART was 34,671 and 45,397 in 2013 but the number served was 9,632 with a

78% unmet need. The number of ART sites was 12 in 2013 and 16 in 2013. For HCT, 320 sites
were set up in 2012 and 365 in 2013; 59,000 were tested in 2012 and 63,000 in 2013. There were
250 PMTCT sites in 2012 and 289 in 2013. Out of 21,769 women eligible for PMTCT in 2011,
only 769 women accessed PMTCT while 1,728 accessed PMTCT services out of 29,892 eligible
women in 2013. It is therefore imperative to rethink the strategy, focus and direction of the
response in terms of addressing issues related to HIV/AIDS in Nigeria. It was observed that
though some progress was being made in monitoring and evaluation in the response at the
national and state level, there were still obvious gaps in data availability and utilization.
(UNAIDS, 2014).
AIMS AND OBJECTIVES
The aim is to investigate the effect of national strategies (2010- To present) in tackling
HIV AIDS among women in the South-West of Nigeria.
There are some specific objective as follows:
 Explore the prevalence of HIV/Aids among women in the South-West of Nigeria.
 Examine the social determinants of HIV/Aids among women in the South-West of
Nigeria.
 Investigate the health and socioeconomic implications associated with HIV/Aids among
women in the South-West of Nigeria.
 Investigate the effect of national strategies (2010- To present) in tracking HIV/Aids
among women in the South-West of Nigeria.
METHODOLOGY
This study was carried out in southwestern Nigeria, which is one of the six Geo-political
zones (southwest, south-south, southeast, north central, northeast and northwest) in Nigeria. The
southwestern of Nigeria constituted six states namely; Lagos, Ogun, Oyo, Osun, Ondo and Ekiti.
It had a provisional population of 27,581,993 people according to 2006 population Census
figures (Federal Republic of Nigeria Official Gazette, 2007).
Secondary data

Secondary data was used for this research. This data is the information includes which
have been already collected and readily available from other sources. Such data are cheaper and
more quickly obtainable than the primary data. Secondary data is basically information which
has been collected previously, by someone else, other than the researcher. Secondary data can
either be qualitative, such as diaries, newspapers or government reports, or quantitative, as with
official statistics, such as league tables.
Secondary data, that was collected by another researcher for some other primary purpose.
The use of secondary data provides a soft landing for researchers who may have limited time and
resources. The examination of secondary data is a workable method which can be use for the
procedure of investigation when a systematic process is followed.
To maintain the secondary research which is the region that conducting the procedure
and defined those methods which research worker is follow. The research method involves how
the researcher collects, analyzes, and interprets the data in the study (Johnston, 2014).
The Advantage of using secondary data in social research
In many domain is a wealthy style content which is available for investigators. Also,
some large data sets might not exist if it wasn’t for the government collecting data. Sometimes
documents and official statistics might be the only means of researching for the past.
Secondary data may be particularly serviceable for making comparisons in all over time.
It is economical, saves efforts and expenses, save time as well as it aid to make primary data
collection more specific by the help of secondary data. we are able to make out what are the gaps
and deficiencies and what additional information needs to be collected, it helps to improve the
understanding of the problem.
Disadvantage of using secondary data
It indicate the partiality who are remain in power that what you can find out. Beside this,
is may lack of authenticity. The component part of the document might be missing because of
age, and even can be verify who wrote the purpose of document. Data from secondary source
may not be the true representation of the population, especially a problem with older documents.
Many documents do not hold up because they are not stored, and others deteriorate with age and
become unusable. Other documents are deliberately withheld from researchers and the public
gaze, and therefore do not become available.

LITERATURE SEARCH STRATEGY
HIV is the Human Immunodeficiency Virus as well as Acquired Immunodeficiency
Syndrome AIDS are global burden of health. It is a virus that attacks cells which assist making a
person more vulnerable, body fight infection and diseases. In 2010 an estimated 2.7 million
population were newly infected with HIV, it is the area only 12% of the global populations. As at
2012 south Africa carries the largest share of the global burden of HIV. In this area approx 6.4
million people, about 12.2% of the population were living with HIV. Standing the country third
among nation with the advanced load of HIV unhealthiness in global after India. (Thron and
Awoleye, 2015).
The outspread of HIV in the last 3 decades has greatly stricken to the health, welfare,
employment and criminal justice sectors; having negative impact on every social phase of
human. Recent epidemiological survey reveals that HIV is still a serious health issue that has
continuously drains our national, regional and state finance having claimed over 25 million lives
over the last 3 decades. Despite the effort of Nigeria government to wipe out the virus, the
country has seen more citizens placed on life saving medication of active anti-retro viral therapy
(AART) to help them live a normal life (Awofala and Ogundele, 2015).
Heterosexual intercourse is the most common means of transmitting HIV in Nigeria,
accounting for over 80% of the cases in the country. (Awofala and Ogundele, 2015).
According to Nigeria National Agency for the Control of AIDS, (2015) the carrier of the
virus in South West Nigeria are female, it is the same situation across the country. Some of the
factors are responsible for this situation that is poverty, marriage, gender-based violence,
masculinity and femininity norms, disabilities, harmful traditional rites as well as human rights,
legal and political factors.
According to World Health Organization, (2015), since the index case was recorded in
Nigeria in 1986, HIV has spread widely among the inhabitants affecting all age group and
ethnicity though at varying degrees. Affected majorly are women (adolescent female, young
adults and teenagers aged 15-24). HIV can be transmitted from one infected individual to another
through unprotected sex and non-sexual activities such as sharing of sharp objects like needle,

non-screened blood transfusion as well as mother to child transmission during pregnancy (Liesl
and Mark, 2013).
Currently, HIV has no ascertain cure but infected persons can be placed on treatment
known as Anti retro viral Therapy (ART) to make them live longer, live a healthier life and also
avoid transmission of the virus to others (Oluyemi et al, 2019).
ETHICAL CONSIDERATION
Public health ethics can be defined as the identification, analysis, and resolution of ethical
problems arising in public health practice and research, has different domains from those of
medical ethics. Assorted methods of moral reasoning have been applied to the ethical decision
making in public health research and practice. Two approaches have figured most prominently:
the principle-based approach to moral reasoning explicated by Beau-champ and Childless, and
case-based methods such as casuistry, this research will focus on Principle based approaches.
Principle-based approaches to moral reasoning were developed to address ethical issues
in clinical medicine and are not necessarily the optimal approach for analyze ethical issues in
public health.
The four principles of beneficence, non maleficence, justice, and respect for autonomy
are germane to public health research. These four principles as explained by Beau champ and
Childress, seek to reduce morality to its basic elements and to provide a useful framework for
ethical analysis in the health professions. The principles do not provide a full philosophical
justification for decision making. However, In situations where there is conflict between
principles, it may be necessary to choose between them or to assign greater weight to one.
Practical problems in public health ethics require that these principles be made more applicable
through a process of specification and reform. (Coughlin, 2006).
The ethical principle of beneficence requires that potential benefits to individuals and
society to be maximized and that potential harms be minimized. Beneficence involves both the
protection of individual welfare and the promotion of the common welfare.
According to this principle, the research will focus deeply on ascertaining the benefits
derived from the people from the intervention. The principle of non-maleficence requires that
harmful acts should be avoided. This study will ascertain if such acts occurred and the effect on
the populace and most especially those leaving with the virus. Respect for the individual is a
principle which grants importance to individual freedom in political life, and to personal

development. This research will also find out the impact of the virus on the political participation
of the carriers and their personal development (Coughlin, 2006).
Utilitarian theories of justice emphasize combination of criteria so that public utility is
maximally utilized. From this perspective, a just distribution of benefits from public health
programs or research is determined and all are affected by the utility. An egalitarian theory of
justice holds that each person should share equally in the distribution of the potential benefits of
health care resources such as screening services. Other theories of justice are of the opinion that
the society has an obligation to correct inequalities in the distribution of available resources, and
that those who are perceived to be vulnerable should get benefit from resources. Such theories
of justice provide considerable support for maximizing benefits to medically undeserved people.
The study will consider the distribution of support to all the states in the region as well as all
affected person in the area (Coughlin, 2006).
PROJECT OUTLINE
The research proposal will comprise of 4 chapters. The first chapter will present the
background and rationale for the study, followed by the key aim and objectives. The second
chapter will present the Methodology. The discussion in this chapter will focus on the chosen,
secondary research and why it was chosen while drawing comparisons with primary research.
This will be followed by detailed literature search strategy and a section on the actual process of
how many papers were identified and eventually utilized. Chapter 3 will present the main body
of the project based on literature reviewed. It will start by discussing the prevalence of
HIV/AIDS among Women in South – West Nigeria.
PROJ ECT TIMETABLE
Action and Targets Time Frames
Incorporating feedback from the proposal 1 February – 14 February 2020
Searching and reviewing literature 15 February – 30 March 2020
Chapter 1 Draft 30 March – 13April 2020
Supervision of chapter 1 Draft 14 April – 21 April 2020
Revise Chapter 1 based on feedback 21 April – 28 April 2020
Chapter 2 Draft Methodology 29 April – 5 May 2020
Supervision of chapter 2 based 6 May – 9 May 2020
Chapter 3 Draft Aim and Objective 11 May – 20 May 2020
Supervision of Chapter 3 based 21 May -25 May 2020
Chapter 4, Draft conclusion and recommendation 25 May – 28 May, 2020

Submission 29 May 2020
REFLECTION
A major challenge faced in the research is that most of the data available did not address
the specific age group. Also, most of the available data were not collected in the study area
(south west Nigeria) as well as but the data was collected in the women in the whole Nigeria. I
was also faced with problem of contradictory data on the internet, probing to know which is
correct is a major challenge.
On the other hand, the use of secondary data for the study has helped seriously.
According to Fellipe and Fernando, (2018), using secondary data in research has proved itself a
valuable approach to finding suitable data for one’s needs without primarily going to the field. It
really reduces the time and cost of doing research and life easier for researchers. With the
experience, I don’t mind doing more research using secondary data.
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