Doctors seeing patients in an HIV clinic in Nigeria.
            In Nigeria there is a distinct lack of HIV testing programmes. In 2007, just 3 percent of health facilities had HIV testing and counseling services, (WHO et al., 2008) and only 11.7 percent of women and men aged 15-49 had received HIV test and found out the results (UNCASS, 2010). In 2010, there were only 1.4 HIV testing and counseling facilities for approximately every 100,000 Nigerian adults, which shows how desperately the government needs to scale up HIV testing services. (WHO et al, 2011) whilst an estimated 2.2 million people aged 15 years and above received HIV testing and counseling in 2010, this amounts to only around 31 people per 100,000 of the total adult population (WHO et al, 2011). Moreover, HIV testing and counseling of pregnant women is central to the prevention of mother-to-child transmission, yet this remains extremely low with only in 7 pregnant women receiving it in 2010.

Sex is traditionally a very private subject in Nigeria, and the discussion of sex with teenagers is often seen as inappropriate. Attempts at providing sex education for young people have been hampered by religious and cultural objections (Odutolu, O et al, 2006). In 2009 only 23 percent of schools were provided life skills-based HIV education, and just about 25 percent of men and women between the ages of 15 and 24 correctly identified ways to prevent sexual transmission of HIV and rejected major misconceptions about HIV transmission (UNGASS, 2010). In some regions of Nigeria, girls marry relatively young, often to much older men in north western Nigeria around half of girls are married by age 15 and four out of five are married by the time they are 18 (the population council, 2007). Studies have found those who are married to younger age have less knowledge about HIV and AIDS than unmarried women and are more likely to believe they are low-risk for becoming infected with HIV. (the population council, 2007). HIV and AIDS education initiatives need to focus on young married women, especially as these women are not likely to have access to health information than unmarried women (the population council, 2007).

            The total number of condoms provided by international donors has been relatively low. Between 2000 and 2005, the average number of condoms distributed in Nigeria by donors was 5.9per man, per year (UNFAA, 2005). Restrictions on condom promotion have hampered HIV prevention efforts. In 2001, a radio advertisement was suspended by the advertising practitioners council of Nigeria (APCON) for promoting messages suggesting that it is acceptable to engage in premarital sex as long as a condom is used (Population service international, 2003). In 2006, APCON also started to enforce stricter regulations on condom advertisements that might encourage indecency (UN Integrated Regional Information Networks, 2006). The number of female condoms sold in Nigeria has significantly increased from 25,000 in 2003 to 375,000 in 2006 (UNFPA, 2007)

Addressing HIV- related issues in Nigeria through television drama as Nigeria is such a large and diverse country, media campaigns to raise awareness of HIV is a practical way of reaching many people in different regions. Radio campaigns like the one created by the society for family health is thought to have been successful in increasing knowledge and changing behavior. ‘Future dream,’’ was a radio serial broadcast in 2001 in nine languages on 42 radio channels. It focused on encouraging consistent condom use, increasing knowledge and increasing skills for condom negotiation in single man woman aged 18 and 34 (population services international, 2003). In 2005, a campaign was launched in Nigeria, in a bid to raise more public awareness of HIV/AIDS. This campaign took advantage of recent increase in owners of mobile phones and sent text massages with information about HIV/ AIDS to 9 million people (BBC News, 2009). Another high profile media campaign is fronted by Femi Kute, the son Fela Kuti, the famous Afro beat musician who died of AIDS in 1997. He appears on bill board a long side roads throughout Nigeria with slogan “AIDS: No dey show for face.‘’ which means you can’t tell someone has AIDS by looking at them (Reuters News Media, 2003 )

Nigeria’s programmes to prevent the transmission of HIV form mother to child (PMTCT) started in July 2002. (National Agency for the control of AIDS, 2010). Despite efforts to strengthen PMTCT interventions, by 2007 only 5.3 percent of HIV positive women were receiving antiretroviral drugs to reduce the risk of mother –to child transmission. This figure had risen to almost 22percent by 2009, but still remained for short of Universal access target which aim for 80 percent coverage.  (WHO et al, 2010). Single –dose nevirapine is no longer recommended for the prevention of mother-to-child transmission. Whildt 19, 733, or 9 percent, of HIV – infected pregnant women received the most effective antiretroviral treatment regimes for PMTCT in 2010, around 6, 505 pregnant women still only received single-dose neviroaine (WHO.. et al, 2011). Coverage for infants remains low; in 2009 only 8 percent of children received antiretroviral for PMTCT (UNICEF, 2010).
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