Chijioke Iremeka
Health professsionals have said the rising cases of adolescent girls living with HIV globally will worsen mother-to-child transmission of the infection if not urgently checked.
The physicians stated that as more young women become infected, the risk of potential vertical transmission was also high since HIV could be transmitted from the mother, not on treatment to the child during childbirth or breastfeeding.
They cautioned that the situation could lead to new generations of children born with HIV, thereby, perpetuating the cycle of infection and increasing the overall burden on healthcare systems.
The United Nations Children’s Fund recently revealed that 75 percent of the new HIV infections among adolescents globally occur in girls.
The Chief of the UNICEF Field Office for South-West Nigeria, Celine Lafoucriere, disclosed this in a statement to commemorate the International Day of the girl-child.
“To ramp up our efforts in the fight against AIDS, there is a need for more concentrated focus on adolescents and young people. New HIV infections among both adolescent boys and girls are not declining nearly quickly enough to reach the 2030 targets,” UNICEF added.
According to Statista, a global data and business intelligence platform, Nigeria’s female population was approximately 110.67 million, while the male population amounted to approximately 113.13 million inhabitants.
Speaking exclusively with PUNCH Healthwise in different interviews, the experts said without targeted interventions, this trend would lead to higher rates of HIV in future generations, exacerbating existing inequalities.
The physicians said the unique needs of female adolescents through comprehensive education, access to healthcare, and support services were essential to breaking the cycle and protecting future generations from HIV infection.
Prof Chris Aimakhu
A Consultant Obstetrician and Gynaecologist at the University College Hospital, Ibadan, Oyo State, Prof Christopher Aimakhu, said females having more cases of HIV infection might increase the risk of mother-to-child transmission.
Aimakhu, who noted that a higher proportion of girls would increase the risk of mother-to-child transmission, stressed the need for proper monitoring of pregnant HIV patients to ensure that the virus was not passed to their babies during or after childbirth.
He noted that the implication of this would mean more people were likely to be infected through them, as many of them who practice risky sexual behaviours, such as not using barriers during sexual intercourse, would get it more and distribute the virus.
Aimakhu, who is also the 2nd Vice President of the Society of Gynaecology and Obstetrics of Nigeria, said such practice would give rise to a cycle of children living with HIV across the country and worsen the fight against HIV transmission.
He said, “The age of infection has changed. The younger ones are getting infected more than the older ones, and they do not have the right information on barrier protection and usage.
“These are risky behaviours that encourage new infections. I have seen a high number of infections in younger people, and I keep asking myself, why do they not protect themselves against sexually transmitted infections?”
Aimakhu, who stated that the non-use of barriers, risky behaviours, and unique women’s anatomy was part of the drivers for the increasing infection among young women, noted that non-access to contraceptives further exacerbates the situation.
On why more girls were getting infected than their male counterparts, he said though the population of women was slightly higher than that of men, women’s bodies were complex and pick up infection faster than that of males.
He said, “Don’t forget that these are the ones mostly being raped, and molested by people with the infection. There are a lot of women that are into risky sexual behaviours. Others are not into transactional sex. So, they are at high risk and will get infected in the process.
“Of course, males have more multiple sex contacts and they spread it to more women. Remember that social media is there, playing its role. They are getting more information on social media and they meet more people on social media. They are sexually active people.”
He recommended advocacy as a way of getting the young people to understand the risk in this form of lifestyle, saying, “We need advocacy, we need to spend more money on these to do school and out of school awareness. We must talk about barrier conception to get it there. However, abstinence is the best.”
Prof Ulu Ogbonnanya
Corroborating Aimakhu’s statement, a Professor of Community Medicine and Public Health at the Ebonyi State University Abakaliki, Ebonyi State, Ulu Ogbonnanya, said having more female adolescents living with HIV patients than male means more infections if nothing is done urgently.
He stated that with more women becoming infected, there is concern that they may give birth to more children with HIV if not properly treated and monitored during and after childbirth.
Ogbonnanya, an infectious disease expert and researcher in HIV/Tuberculosis management, pointed out that both biological and social factors contribute to this trend.
On social factors, he noted, “Some men have multiple sexual partners, and when they become infected, they often transmit the virus to their next partner, perpetuating the cycle. The same occurs with adult males; when they contract the virus, they can bring it home and pass it on to their spouses.
“Also, remember that poverty wears a feminine face rather than a masculine one. Many young girls engage in transactional sex due to social pressures. Some may not want to have sex but feel compelled to do so for money, often with men who have multiple partners.
“Some of these men like to have sex without protection because they want to feel the fresh contact. She may not want to do it but because of her social needs at the moment, she would give into having unprotected sex and other risky behaviours.”
On the biological makeup of women, he explained, “Anatomically, the vagina is more open than the male penis, making it more susceptible to infection. Also, micro-abrasions can occur during intercourse, which are less common in men. These differences contribute to a higher risk of infection for females compared to males.”
He further noted that the male-to-female population ratio in Nigeria is nearly equal, and so cannot explain why girls have higher rates of HIV than boys, insisting that the reasons lie in the factors he previously discussed.
While proposing solutions, he emphasised, “We need to target women with education and empower them to insist on protection during sexual encounters. We must create awareness in marketplaces, schools, churches, and other social venues.
“In some areas, they used what is called Pre-exposure prophylaxis. PrEP is a medicine taken to prevent getting HIV and it is effective for preventing HIV when taken as prescribed, though some people argue that PrEP encourages risky sexual behaviours among young people.
“In South Africa, for instance, people use PrEP to reduce the risk of getting HIV from sex by as high as about 95 percent. PrEP reduces the risk of getting HIV from injection drug use by at least 74 percent.
“The drugs neutralise any virus that might want to infect the person and it will not affect them even if they have sex with a HIV positive partner. But generally, what we need is to be faithful to one’s partner and do away with multiple sexual partners and risky behaviours.
“For those who have it and are pregnant, they need quality antenatal services. They need to be monitored till they are delivered of the babies. Normally, they give birth through CS to reduce the risk of infecting their unborn babies.”
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