HIV in Nigeria and Older Adults Flashcards
What 3 countries have the highest HIV prevalence?
- South Africa
- Nigeria
- India
How many people in Nigeria are infected with HIV?
3.3 millon
Which 3 countries have the highest adult prevalence rate?
- Swaziland (25.9%)
- Botswana (24.8%)
- Lesotho (23.6%)
When was the first HIV case reported in NIgeria?
1986
How much of the HIV transmission in NIgeria is from heterosexual intercourse?
80%
What are the 3 key populations at higher risk in Nigeria?
- CSW (24%)
- MSM (17%)
- IDU (4%)
What age group in Nigeria has the highest prevalence rate?
30-34 years
What is the most vulnerable population for HIV in Nigeria?
women and girls (58% PLWHA)
Prevalence is _______ higher among ___________ aged __________ years than _________ counterparts.
Prevalence is 3times** higher among **women aged 15-24 years than male counterparts.
What are the key drivers of the epidemic?
- Illiteracy*
- 35 million adults
- Low health literacy
- lack of access to health information
- Poor health seeking behavior [antenatal care]
- Low HIV knowledge
- Low perceived personal susceptibility
- High rates of untreated STDs**
- Stigma/Discrimination [normative beliefs]
Additional key drivers of the epidemic?
-
Poverty*
- lack of economic empowerment - transactional sex
-
Gender inequality [cultural beliefs]*
- foster male dominance, sexual violence
- Lack of control [marriage, sexual negotiation]
- Lack of legal protection
-
Traditional practices*
- female genital mutilation
- early & forced marriage
- wife inheritance
- Low condom use**
- Multiple concurrent sexual partners
What are some challenges to HIV prevention efforts?
- Poverty
- 100 million people (71.5%) live on <$1 a day 1
- Stigma/discrimination
- Persistent cultural norms and practices 2
- patriachal family structure
- polygamy
- domestic violence
- prostitution
- incisions (eg. circumcision, herbal medicine)
- culturally imposed traditions and norms that discriminate against women [female circumcision, wife inheritance, disinheritance of widows, “Sirah syndrome”, offering of women to guests, formal mistress).
What are some system related challenged to HIV prevention efforts?
System-related issues
- Poor funds administration
- Lack of accountability
- Lack of sincerity/Ulterior motives
What are the 2 major challenges for PLWHA in Nigeria?
- *Stigma/Discrimination [Lack of protective legislation]**
- social
- education
- job
- *Access to treatment & care**
- rural areas
- HIV orphans [2.2 million]
What are some culturally sensitive age related terms for “older” adults?
Aging related terminology
Seniors
Elderly
Old
Aged
How many adults 65 and older were diagnosed with HIV in 2011?
948
What are some risk factors for older adults and HIV?
- Less knowledgeable about HIV/AIDS and STIs than younger age groups
- Less likely than younger people to talk about their sex lives or drug use with their physicians
- Doctors may not ask their older patients about their sex lives or drug use
- Less likely to use condoms
- Lack of perceived perceptibility
- Lack of education that included condom use
- Post menopausal women
- Thinning of vaginal tissues
- Decrease in natural lubricant
What can be said about older adults and HIV testing?
HIV Testing
- Less likely than younger people to get tested
- May be ashamed or afraid of being tested
- Older persons of minority races/ethnicities may face discrimination & stigma that can lead to later testing, diagnosis, & reluctance to seek services
What are the CDC’s routine testing recommendations for older adults and other populations?
Routine HIV screening for adults & adolescents, including pregnant women, in health care settings in the United States
- The recommendations specify routine testing for persons aged 13 – 64
Persons aged 64 & over should be counseled to receive HIV testing if they have risk factors for HIV infection
What are the specific treatment guidlines for older adults?
- No specific treatment guidelines currently available that focus on management in the older HIV-infected adults
- Limited information on the efficacy & safety of selected antiretroviral regimens for older patients
What can be said about HIV treatment side effects and older adults?
Medication side effects in general tend to be higher in older patients and may be related to age associated declines in hepatic and renal function.
What are the CDC’s prevention strategies for older adults?
** CDC Prevention Strategies**
- Education to increase awareness and knowledge
- Skills Training to help with negotiating risk-reduction behaviors
- intervention strategies to help older women negotiate safer sexual behavior are especially important
- Messages that are age-appropriate and culturally sensitive
