IJAIYA, Muftau Adeniyi
Accounting & Finance
Senior Lecturer
Causes and Socio-Economic Consequences of HIV/AIDS in Kwara State.
Nigeria Journal of Legislative Affairs. 3 (1&2): 141-158, (A Publication of
Policy Analysis and Research Project (PARP), National Assembly of
Nigeria, Maitama, Abuja).
158
CAUSES AND SOCIO-ECONOMIC CONSEQUENCES
OF HIV/AIDS IN KWARA STATE
G.T. Ijaiya1, A. Usman1, M.A. Ijaiya3, L. A. Alabi4, M. Ijaiya5
1
2
Department of Economics, University of Ilorin, Nigeria
Department of Accounting and Finance, University of Ilorin, Nigeria
3
4
Kwara State Planning Commission, Ilorin, Nigeria
Department of General Studies, Federal University of Technology, Minna, Nigeria
Abstract
Using a collection of household data and the Weighted Rank Analysis, this article examined the
most likely causes and socio-economic consequences of HIV/AIDS in Kwara State. The results
obtained revealed that the most likely cause of HIV/AIDS in the State was not clearly known by
the people living with the virus. "Unknown cause" is understood to be a result of the years it
takes the virus to manifest into full-blown AIDS. The most likely cause of HIV/ AIDS, as
claimed by the respondents, was sexual intercourse followed by transfusion of contaminated
blood or blood products, re-use of contaminated needle, blade, clipper and reuse of contaminated
syringe in that order. The least likely cause of HIV/AIDS was therefore the re-use of
contaminated surgical equipment in modern and traditional medical setting. The most severe
socio-economic consequence of HIV/AIDS in Kwara State was discrimination/ stigmatization,
having been rated first in the study, followed by increase in health care spending,
psychological distress and shame, reduction in household saving/consumption, reduction in
household income, reduction in labour productivity and reduction in child and household care,
in that order. Given these results the article has suggested measures that can be used to alleviate
the plight of the people living with HIV/AIDS ( PLWHA).
Introduction
Available data on the prevalence of HIV/AIDS in Nigeria which stood at about 3.1% of the
adults in 2007 still call for concern, given the devastating impact of the virus on the socioeconomic life of the people (PRB 2008). Although regarded as one of the HIV/AIDS low-risk state
in Nigeria, Kwara State, with about 2.8 percent cases in 2005, is still confronted with the
problem of curtaining the virus because the causes are unabating and the consequences severe
(KWSG/UNDP 2007). The severe consequences of HIV/AIDS could be viewed from the point
that the disease is not just a public health problem but it also has far-reaching consequences for
all social sectors and for development.
159
As a health problem, HIV/AIDS has led to increase in morbidity and mortality which
subsequently has created a development problem due to a massive fall in productivity of
individuals and the countries affected, increase in the cost of health care services, decline
in savings and capital formation (since funds needed for such are diverted to the treatment
and care of the victims), decline in spending on education, higher expenditure on caring for
orphans left behind by those killed by the disease, high level of poverty, food insecurity and
malnutrition.
For instance, in 2003, the estimated number of AIDS orphans was put at 1.8 million and
in 2005 the cost of health care services increased because an estimate of 598,000 people
living with HIV/AIDS had to be catered for with antiretroviral therapy. The upsurge in HIV/
AIDS has also led to increase in infant mortality rate and fall in life expectancy at birth. In
Nigeria, the infant mortality rate and life expectancy at birth in 2007 were 100 per 1000 and
44 years respectively which are pathetic when compared with that of Morocco that had 44
per 1000 infant mortality rate and 70 years as its life expectancy rate. This situation that also
reflects the level of economic activities in the country given the level of its per capita income
(US$1,770), which is far below that of Morocco that was US$3,990 in 2007(PRB 2008).
It is against this backdrop that this article sought answer to the following question. What
are the key causes and consequences of HIV/AIDS in Kwara State? The rest of the paper is
structured as follows: Section Two provides a conceptual and empirical overview of HIV/
AIDS, while section Three discusses the study area and provides the methodology. Section
Four presents and discusses the results. Conclusion and recommendations are contained in
the last section.
HIV/AIDS: Conceptual clarification
Meaning of HIV/AIDS
Human Immuno-deficiency Virus (HIV) is that virus that destroys the body immune system
and Acquired Immune Deficiency Syndrome (AIDS) is the full blown break down of all
body immunity that leads to a group of serious illnesses and opportunistic infections. HIV
infection is caused by two strains of the human immune deficiency virus, HIV-1 and HIV-2.
HIV-1 is the more common form that is predominant in different parts of the world, while
HIV-2 is found predominantly in West Africa and some parts of Angola and Mozambique.
When compared with HIV-1, HIV-2 is less infectious and its clinical course is slower. Dual
infection with HIV 1 and HFV 2 is possible. Once introduced into the human body, HIV
attacks mainly a subset of immune system cells, which bear a molecule called Cluster
Designation 4 (CD4). Specifically, the virus binds to two types of CD 4- bearing cells: Cluster
Designation 4+Lymphocytes (CD4+T)-cells and macrophages. These cells perform various
160
tasks critical to the normal functioning of the immune system. CD4+ T-cells organize the
overall immune response by secreting chemicals to help other immune cells work properly,
while macrophages engulf foreign invaders and prime the immune system to recognize these
invaders in the future (see World Bank 1997; Lamptey, et.al 2002; WHO 2003).
Causes of HIV/AIDS
HIV can be transmitted through sexual intercourse, blood and blood products such as unsafe
blood transfusion, use of unsterilized instruments, traditional practices involving cuts,
mother to child transmission during pregnancy, delivery and breast feeding, organ and tissue
transplant. HIV cannot be transmitted by a sneeze, a handshake or other casual contact. In
developing countries, heterosexual intercourse accounts for a great proportion of cases.
(Bulatao and Bos 1992; World Bank 1997; O'Malley 2002; Robalino, et.al 2002).
According to Bonnel (2000), several economic, socio-cultural and epidemiological variables
account for the spread of the HIV/AIDS. The main economic variables are poverty, gender
inequality, income inequality and the extent of labour migration. Poverty, gender and
income inequality make societies more vulnerable to HIV. For instance, a poor woman will
find herself at much greater risk of HIV infection than a poor man. Unequal regional
development among countries as well as within countries can induce labour migration to
urban areas or other countries. The resulting concentration of single men in urban areas or
project sites is generally accompanied by a parallel increase in commercial and casual sex,
with a concomitant rise in the risk of HIV infection. The socio-cultural variables include the
type of sexual relations, religious belief, the economic structure of societies and social
conflicts. For instance, the type of sexual relations is important because it affects the relative
spread of HIV among men and women. In some parts of Asia, HIV is mainly spread through
heterosexual relations. The epidemiological variables include co-factors that increase the risk of
sexual contacts resulting in HIV infection. Recent epidemiologic studies have implicated
genital/anorectal ulcer disease and non-ulcerative sexually Transmitted Diseases (STD) as
important co-factors in the acquisition and transmission of HIV during sexual intercourse
(Lamptey, et.al 2002; Olumide and Mohammed 2004).
Consequences of HIV/AIDS
As observed by Cuddington (1993), World Bank (1993a), Ainsworth and Over (1994), World
Bank (1995), World Bank (1997), Robalino, et.al (2002), Bell, et. al (2003), the effects of
HIV/AIDS can be grouped into two categories; those associated with rising morbidity rates
and those associated with rising mortality rates for particular age cohorts, especially sexually
active adults and children infected at birth. The rise in morbidity has three immediate effects:
reduction in labour productivity, increase in health care spending and reduction in savings.
The negative effect on productivity will arise because sick or worried workers are less
productive than happy and healthy workers. Even the productivity of those who do not have
161
AIDS may fall as infection and illness rates among friends, families and co-workers rise.
The health care expenditure effect refers to increase expenditures by households and the
(public or private organizations) on health care systems to assist AIDS patients and their
families in coping with deteriorating health. The effects on saving can be seen*from the
direct effect of higher medical expenditures which tend to reduce saving and the growth of
per capita, life expectancy, age structure, and the healthiness of the population.
The fall in domestic savings will imply a reduction in capital formation, and if it is substantial,
it will have a potentially large adverse effect on per capita income on the long term. On the
other hand, the gradual rise in mortality rates caused by AIDS will have two important
demographic aspects with macroeconomic consequences. First, there will be a slower
population growth rate, which will result in a smaller population at a future date. Second,
rising number of deaths from AIDS will shift the age structure of the population towards the
younger age cohorts. The shifts in age structure can be expected to have important effects on
both aggregate supply and aggregate demand. On the supply side, the size of the workingage population (and perhaps the participation rate of the labour force) will be reduced. The
smaller working-age population will directly reduce potential output. The loss in output
would be exacerbated by a fall in labour force productivity as the average age and experience
of the labour force declines. On the demand side, the shift in the size and composition
of the population will affect the level and composition of public expenditures as well as
the economy's overall (private and public) saving rates. For example, the smaller absolute
number of young people will place lower demands on the education system and the overall
consumption rates will be higher because of the younger age structure (see also World Bank
1993b; Ainsworth 1998; Over 1998; Squire 1998; Ainsworth and Filmer 2002; Crafts
and Haacker 2004; Haacker 2004).
Barrett and Rugaleman (2001) and Wilson (2001) submit that other consequences of HIV/
AIDS include household food insecurity and high levels of malnutrition among children,
especially orphans who, because of the death of infected adults that are farmers, are deprived
sufficient food. The death of young adults through HIV/AIDS also reduces households'
earning power and therefore their ability to buy food and related goods and services. Illness
and funerals would force households to spend most of their cash on care, treatment and
other expenses, with adverse consequences for food availability. Labour shortage also forces
households to forgo cash in favour of fast-maturing food crops, thus curtailing the ability
of afflicted households to generate cash. The death of the productive adults also shatters the
social networks that provide households with community help and support. Survivors are left
with few relations upon whom to depend. Widows and their children face critical shortages
of food and income, primarily due to disinheritance, lack of sufficient assets, lack of labour
supply and exclusion from wider kinship networks (see also Barrett and Whiteside 2000).
162
Trend of HIV/AIDS in Nigeria
In Nigeria, the first HIV sentinel surveillance was established in 1991 as a means of
monitoring HIV/AIDS in the country. In 2007, the prevalence rate of HIV/AIDS was put
at 3.1 percent of the adult population, a slight drop from 4.4 percent that was recorded in
2005. At the state level, a 2005 survey conducted show that all the 36 states and Abuja (the
Federal Capital Territory) reported cases of HIV/AIDS, with the rates varying significantly
from state to state. As indicated in Table 1, the states with the highest prevalence rates were
Benue (10.0 percent) and Akwa Ibom (8.0 percent). The states with the lowest prevalence
rates were Ekiti (1.6 percent), Jigawa (1.8 percent), Oyo (1.8 percent), Kastina (2.7 percent)
and Kwara (2.8 percent).
Table 1: HIV/AIDS Prevalence in Nigeria 2005
States
Abia
Adamawa
Akwa Ibom
Anambra
Bauchi
Bayelsa
Benue
Cross River
Delta
Ebonyi
Edo
Ekiti
Enugu
Federal Capital Territory
Gombe
Imo
Jigawa
Kaduna
Kastina
Kebbi
Kogi
Kwara
Lagos
Nasarawa
Niger
Ogun
Ondo
Osun
Oyo
Plateau
Prevalence Rate in %
4.0
4.2
8.0
4.2
3.4
3.8
10.0
6.1
3.7
4.5
4.6
1.6
6.5
6.3
4.9
3.9
1.8
5.6
2.7
4.0
5.5
2.8
3.3
6.7
5.3
3.6
3.2
2.0
1.8
4.9
163
Rivers
Sokoto
Taraba
Yobe
Zamfara
.5.4
3.2
6.1
3.7
3.0
Sources: Nigeria HIV info (2006) and Tamen (2006)
Study Area and Methodology Study Area
The focus of this study is Kwara State, which was created on the 27th May 1967. The State occupies a
geographically vantage position on the map of Nigeria because it is situated between Latitudes 11° 2'and 11°
45'N and between Longitude 2° 45' and 6° 4' of the Equator. It also lies midway between the Northern and
Southern parts of Nigeria bounded in the North by Niger State and shares international boundary with the
Republic of Benin in the West. To its eastern border is Kogi State, while in the south it shares boundary with
the three states of Ekiti, Osun and Oyo. The State is covered by the Sudan and woody Savanna vegetation
with a mean annual rainfall and temperature of l,338mm/year and 26.5OC respectively. The State has 16 Local
Government Areas namely, Asa, Baruten, Edu, Ekiti, Ilorin East, Ilorin South, Ilorin West, Ifeludun, Irepodun,
Isin, Kaiama, Moro, Offa, Oke Ero, Oyun, and Patigi. The total population of the state is estimated
at2.2.million people (KWSPC 2004; KWSG 2008).
Methodology
In addition to the use of secondary data, a survey aimed at generating primary data on the causes and the
socio-economic consequences of HIV/AIDS in Kwara State was conducted between the month of April and
July 2007, using a structured questionnaire and a Participatory Rapid Appraisal (PRA) method (see Valadez and
Bamberger 1994; Dawan, et al undated).
Sample and Sample Selection Methods
This study was supposed to be a state-wide research, to be conducted by the distribution of structured
questionnaire to some of the people living with HIV/AIDS in Kwara State, but it was difficult to identify
the people living with the virus, so we had to interact with the HIV/AIDS units in the University of Ilorin
Teaching Hospital, the Kwara State Ministry of Health, as well as the Coordinator of the Kwara State
Action Committee on AIDS. With the assistance of these units, we were able to identify the people living
with HIV/AIDS. From the administered questionnaire, only 156 out of 201 of the people living with
HIV/AIDS responded.
164
The issues raised in the questionnaire include the background of the respondents (i.e. location of the
respondents, age, gender, martial status, religion, educational and occupational status), the
likely causes of the disease, the consequences of the disease (e.g. on health care spending,
productivity, income, household consumption, household care, children education, discrimination
and stigmatization in the society, psychological distress and shame). Questions on access to
diagnoses, treatment and cure were also raised.
Statistical Analysis
The data collected were first examined for omissions, errors and inconsistency before the
analysis. Descriptive statistics, such as percentile was used in describing the socio-demographic
characteristics of the respondents who were people living with HIV/AIDS in Kwara State. In
determining the most likely cause(s) and most severe consequence(s) of HIV/ AIDS, a Weighted
Rank Analysis (WRA) was used (see Arosanyin 1999). To complement this method of analysis,
the respondents were asked about their perception of the causes and the consequences of
HIV/AIDS through a Participatory Rapid Appraisal (PRA) method, which include, among other
methods, the use of an in-depth interview.
Results and Discussion
Table 2: Socio-demographic Characteristics of the Respondents
Characteristics
a.
b.
Percentage (%)
Location of the Respondents
Urban areas
Rural areas
Age of the Respondents
68.6
31.4
28.8
69.7
1.5
16-30 years
c.
d.
e.
f.
31-60 years
Above 60 years
Gender
Male
Female
Marital Status of the Respondents
Single
Married
Divorced/Separated
Widow/Widower
Religion of the Respondents
Islam
Christianity
Others
Household Size of the Respondents
_j
31.4
68.6
10.9
66.7
4.5
17.9
57.7
42.3
-
165
g-
h.
1-5
6-10
65.4
30.2
Vlore than 10
4.4
"No. of Children
None
1-5
6 -10
Above 10
No. of Adults
None
1-5
6-10
I
j-
Above 10
No. of Elders
None
19.2
Head of Household
58.3
41.7
Occupational Status of the Respondents
Organized Public Sector
Unemployed
Schooling
n.
80.8
-
Organized Private Sector
m.
3.1
80.1
16.2
.6
6 -1 0
Above 10
Head of Household
Self Employed
1.
78.3
1.2
-
1-5
Not Household Head
k.
20.5
Educational Status of the Respondents
No school
Primary school
Secondary school
Tertiary
Quranic Education
Income of Respondents
Less than N5000
N5001-N10000
Above N 10000
Consumption-expenditure of Respondents
Less than N5000
N5001-N10000
Above N 10000
Source: Authors' Computation from fieldwork, 2007.
58.3
3.7
14.7
12.8
7.1
17.9
30.8
30.1
20.5
.7
50.8
18.6
30.6
33.3
22.2
44.5
166
Socio-demographic characteristics of the Respondents
In the course of this survey, certain features were identified as typical of the people living with
HIV/AIDS in Kwara State. These features include the location of the respondents, the age
range of the respondents, their gender, marital status, religion, household size, and occupational
and educational status. As indicated in Table 2, the result of the study on the socio-demographic
characteristics of the people living with HIV/AIDS in Kwara State shows that 68.6 percent of
them reside in urban centers, with 68.6 percent of them being female, 69.7 percent of them are
aged between 30 and 60 years and 66.7 percent of them married. The study also revealed that
58.3 of them are heads of their households and 60.9 percent and 14.7 percents were self
employed and engaged in public sector activities respectively. Most of the respondents are lowincome earners, with 50.8 percent of them earning less than =N=5000.00 every month.
The implication of this finding is that HIV/AIDS in Kwara State is largely an urban
phenomenon, with low-income earners and women being the most vulnerable. The study also
revealed that the adult work force is the most affected, which has implication for the state's
level of productivity and economic activities.
Causes and consequences of HIV/AIDS in Kwara State, Nigeria
Based on the questionnaire, some possible causes and the most severe socio-economic
consequences of HIV/AIDS in Kwara State were drawn. Table 3 summarizes the results of the
possible causes of HIV/AIDS using the Weighted Rank Analysis, which provides a measure of
the most likely cause of HIV/AIDS in Kwara State. As revealed by the study, the most likely
cause of HIV/AIDS is not clearly known by the people living with the virus having been rated
the first with 20.4 percentage score. That the cause of HIV/AIDS is unknown is understood
to be as a result of the years it takes the virus to manifest into a full-blown AIDS. The
perception of some of the respondents is not at variance with the percentage that responded
"unknown ". To them they cannot specify how they contracted the disease. The second most
likely cause of HIV/AIDS is through sexual intercourse with a percentage score of 19.5 percent.
That this is the second most likely cause of HIV/AIDS is drawn mostly from some of the women
that are infected with it, which in turn is linked to their husbands that are either critically ill or
dead as a result of the virus. Transfusion of contaminated blood or blood products, re-use of
contaminated needle, blade, clipper, re-use of contaminated syringes are the third, fourth and
fifth most possible causes of HIV/AIDS, respectively. The less possible cause of HIV/AIDS is
the re-use of contaminated surgical equipment in modern and traditional medical setting.
167
Table 4 summarizes the results of the most severe socio-economic consequences of HIV/
AIDS in Kwara State using also the Weighted Rank Analysis. The most severe consequence
of HIV/AIDS in Kwara State is discrimination/stigmatization having been rated first with
16.5 percentage score, followed by increase in health spending with a score of 13.8 percent.
Psychological distress and shame, reduction in household saving/consumption, reduction in
household income, reduction in labour productivity, and the negative effect it has on children
education are third, fourth, fifth, sixth and seventh, respectively. The less severe consequence
is the negative effect it has on household care.
The perception of some of the respondents was not at variance with the findings above. For
instance, increase in health care spending witnessed by some of them was a result of the need
to cope with deteriorating health and the need to regularly visit the clinic for a diagnostic test,
which is expensive, and for drugs which has just been made free to them. Low productivity
as revealed by the study is as a result of sickness and worried/ psychological distress that
comes with HIV/AIDS. For some of the widows, they are already faced with the problem of
shortages of job, care, food and income primarily because of disinheritance, lack of sufficient
assets and exclusion from kinship networks at the household and community levels. Some of
the men among them have also lost their jobs because they were HIV positive. There was a
case of a taxi driver who lost his job from the fear by the owner of the taxi that he might be
infected with HIV by the driver if he retained him. There was also the case of a woman who
was divorced by her husband and was asked to take her children along with her because of
the fear that her children too must have been infected with the virus.
168
Table .3: Most Probable Causes of HIV/AIDS in Kwara State
FREQUENCY
N
NL
Total Score Per Cause
nfHTV/ATDS
Total
Total %
Score
Cumulative
Rank
(CR)
3
2
1
3
2
1
156
68
4
84
204
8
84
300
Per
Cause of
HIV/
AIDS
19.5
156
31
8
117
93
16
117
226
14.7
5th
156
29
7
120
87
14
120
221
14.4
6th
156
37
7
112
111
14
112
237
15.4
156
35
9
112
105
18
112
235
15.3
156
78
1
77
234
2
77
313
20.4
1532
100
VARIABLE
Sexual Intercourse
ML LL
2nd
a.
b.
c.
d.
e.
f
Re-use of
contaminated
Syringes
Re-use of
contaminated
surgical
equipment in
modern and
traditional medical
setting
Transfusion of
contaminated
blood or blood
products
Re-use of
contaminated
needle, blade,
clipper, etc
Not known the
Cause (s)
Total
3rd
,
4*
1st
KEY: N = No. of observations, ML= Most Likely, LL = Less Likely, NL = Not Likely Source: Authors'
Computation from fieldwork, 2007.
169
Table .3: Most Probable Causes of HIV/AIDS in Kwara State
FREQUENCY
N
VARIABLE
b.
c.
d.
e.
f.
ML
LL
NL
Total Score Per Cause
Total
ftfHTV/ATDS
3
2
1
3
2
1
Total %
Score
Per
Rank
Cause of (CR)
HIV/
Ams
2nd
19.5
Sexual Intercourse
156
68
4
84
204
8
84
300
Re-use of contaminated Syringes
156
31
8
111
93
16
117
226
14.7
5th
156
29
7
120
87
14
120
221
14.4
6th
156
37
7
112
111
14
112
237
15.4
3rd
156
35
9
112
105
18
112
235
15.3
4th
156
78
1
77
234
2
77
313
20.4
p,
1532
100
Re-use of contaminated surgical
equipment in modern and
traditional medical setting
Transfusion of contaminated blood
or blood products
Re-use of contaminated needle,
blade,
clipper, etc
Not known the Cause (s)
Total
KEY: N = No. of observations, ML= Most Likely, LL = Less Likely, NL = Not Likely Source: Authors'
Computation from fieldwork, 2007.
170
Table 4: Most severe socio-economic consequence of HIV/AIDS in Kwara State
FREQUENCY
VARIABLE
N
MS
S
LS
Total Score Per
Consequence of
HIV/AIDS
Total
^
Total %
Score Per
Consequence
of HIV/AIDS
Cumulative
Rank (CR)
a.
Reduction in Labour Productivity
3
156 53
2
11
1
92
3
159
2
22
1
92
273
11.3
6th
b.
Increase in Health Spending
156 71
37
48
213
74
48
335
13.8
2nd
156 61
31
64
183
62
64
309
12.7
4*
156 50
30
76
150
60
76
286
11.8
5th
d.
Reduction in Household Saving/
Consumption
Reduction in Household Income
e.
Effect on Household Care
156 32
20
104 96
40
104
240
9.9
8th
f.
Effect on Children Education
156 36
24
96
108
48
96
252
10.4
7th
g-
Discrimination/Stigmatization
156
16 22
348
32
24
402
16.5
(st
h.
Psychological distress / Shame
Total
156 71
28
213
56
57
326
2423
13.6
100
c.
116
57
KEY: N = No. of observations, MS =Most Severe, S = Severe, LS = Less Severe Source: Authors'
Computation from fieldwork, 2007.
/
rd
3
/
171
Table 5: Access to Medical Attention and Frequency of Visits for
Medical Attention by People Living with HIV/AIDS in Kwara State
VARIABLE
a.
Access to Medical Attention
Diagnosis
9.0
Drugs
10.2
80.8
Diagnosis and Drugs
b.
Percentage (%)
Frequency of Visits for Medical Attention
Monthly
64.1
Every Three Month
Every Six Month
34.6
Yearly
1.3
-
Source: Authors' Computation from fieldwork, 2007.
The study, as indicated in Table 5, revealed that 80.8 percent of the people
living with HIV/ AIDS in Kwara State had access to medical attention and
64.1 percent of them visited the nearest medical center monthly (which is the
University of Ilorin Teaching Hospital), because of its proximity, quality of
service and availability of diagnostic test and drugs. The visit by other patients
after every three months (especially those living in rural areas) was because of
distance, travel time and cost of travel to the Teaching Hospital, which seems to
be the only one available for diagnostic test, drugs and care.
Recommendations and
Conclusion
Recommendations
Based on the findings of this study, the following recommendations are made:
• All factors causing HIV infection should be eliminated through
enlightenment campaign and orientation, the expansion of socioinfrastructural facilities in the rural areas and in urban slums in order to
reduce the drift of people from one place to the other, and the use of
legislation. The legislation should be such that would prevent
the use of unsafe blood for transfusion, use of unsterilized instruments and
traditional practices involving cuts, especially in the rural areas that are
more vulnerable to the spread of the disease. There should also be
legislation on sex workers.
• To enhance the State government efforts at prevention, detection and
treatment, the State House of Assembly should come up with a legislation
that would mandate the government to allocate not less than 10 percent
of the funds budgeted to the health sector for HIV/AIDS care services,
especially for low income earners that are living with the disease, as well
as HIV/AIDS service organizations that provide medical and nonmedical assistance to those living with the disease.
'
172
•
To intensify campaigns at the school level, there should also be a legislation that
would require all schools to integrate into their curriculum the subject of HIV/
AIDS.
•
Since discrimination and stigmatization against the people living with HIV/AIDS
has taken a critical dimension in the State, the State House of Assembly should also
pass Laws against them and enforce these Laws through relevant sanctions.
•
The slogan that "HIV/AIDS is a killer disease that can not be treated" and the "skull
and bone symbol" used as indication of how deadly HIV/AIDS is should be discarded
and replace with the slogan that "HIV/AIDS can be managed", especially for those
already infected. This is important given the cases of death already recorded, since
the thought is that if infected with HIV/AIDS the consequence is death, so why waste
your time looking for medical attention.
•
Policies and programmes on HIV/AIDS should go beyond care and support for
the infected to include prevention. This is because no matter how wide-spread the
mitigation efforts are, the devastating impact of HIV/AIDS will continue unabated.
•
The State government should work unrelentingly to reduce poverty level in the state.
This is because certain conditions have to change before behavioural change can be
attained. For example, economic empowerment for the less privileged and the most
vulnerable, most of them women is essential. Removing institutional bottlenecks to
the creation and expansion of small and medium scale enterprises and rural credits is
necessary. Promoting women's education and enhancing their status is also essential
in preventing and reducing the spread of HIV/AIDS in the State.
•
The government of the State should also provide equal access to productive
resources, social services (like health care, safe water, food and nutrition to the most
affected), and diagnostic equipment and drugs in all the clinics in the wards at the
local government area levels, given the difficulties faced by those affected with the
disease in the rural areas. In this connection, improved access should be facilitated
for the people at the rural areas. Because it is believed that the more access people
living with HIV/AIDS' have to these facilities, the longer they are likely to live.
•
Equally important, the prevention and management of HIV/AIDS in the State should
be viewed as a component of good governance.
173
Conclusion
The important conclusions of this study are as follows:
•
•
HIV/AIDS in Kwara State is an urban phenomenon because 68.6
percent of the
people living with were found there.
The most vulnerable groups were the low-income earners and mostly the
adult female
work force, and by this implication affect the State's productivity and
economic
activities.
•
Most of the people living with HIV/AIDS in the State did not know
how they got
infected. However, most of the affected women did not rule out sexual
intercourse,
because their husbands were either dead or critically ill.
•
The most severe consequence in the study area was
discrimination/stigmatization
that had led to loss of jobs, divorce, rejection and exclusion from kinship
networks
at the household and community levels, followed by increase in
spending on health
care services, which affected spending on other household needs.
•
Majority of the people living with HIV/AIDS in the urban areas had access
to medical
attention, while those in the rural areas have limited access to medical
attention.
End Note
1
The 4 Local Government Areas selected from the three Senatorial Districts of
Kwara State gave us a total of 12 Local Government Areas which included
the following: Ilorin East, Asa, Baruten, Edu, Ilorin South, Ilorin West,
Irepodun, Isin, Kaima, Offa, Oyun and Moro.
Acknowledgement
We wish to acknowledge the immense contributions of the following people in
the preparation of this report: Mrs. Salimat Lawal, Assistant Director in
charge of HIV/AIDS-related matters in the Kwara State Ministry of Health,
Ilorin, Nigeria and Mrs. Halimat. O. Ijaiya, Laboratory Technician in the
Department of Haematology, University of Ilorin, Teaching Hospital, Ilorin,
Nigeria.
174
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