On the Right to information and HIV/AIDS Prevention

At the end of 2005, 6.1 million people in Nigeria are estimated to be living with HIV/AIDS. More than 3.2 million of these people are between the ages of 15-49, [1] indicating a high prevalence of the HIV infection among young adolescents and adults.  An explanation for the sporadic spread of HIV epidemic in Nigeria can be traced to insufficient information about HIV/AIDS preventive methods, and until Nigerian youths are armed with adequate information about HIV/AIDS, its mode of transmission, and feasible measures of how to protect themselves, little or no progress will be achieved with regards to reducing the transmission of the virus.

Prevention of HIV/AIDS deals with multiple strategies that work synergistically to reduce risk of HIV/AIDS transmission. It includes raising awareness about HIV/AIDS and advocating for ABC of prevention (Abstinence, be faithful to partner, and Use of Condom). It also includes; making antenatal antiretroviral regimens available to pregnant women to help reduce mother to infant transmission, and the adoption of more intensive targeted behavioral interventions with the aim of building motivation and risk-reduction skills amongst populations especially at high risk. Such population may include migrant workers, drug addicts, prostitutes, and other vulnerable groups.
                                          
Adequate information about HIV/AIDS preventive methods especially campaigns promoting the use of condom is likely to come under serious constraint when the Nigeria Code of Advertising Practice start to be more strictly enforced by 1 July 2006, says PLUSNEWS. [2]   The code would allow the Advertising Practitioners Council of Nigeria (APCON), the statutory body charged with vetting and approving advertisements, to crack down on the effective and widespread advertisement of condoms in the country.

Citing the code, the Panel Chairman Emmanuel Ekuno warned against condom advertisements that might encourage indecency or which in any way dramatized, depicted or insinuated a sexual act by use of word, graphics, sound or action.   In addition, all condom advertisements are required to carry health warnings, may not be aired on children's programmes, before 8.00 pm on radio and television, or displayed on billboards near places of worship, schools and hospitals. [3]

This directive by APCON has been subjected to a barrage of criticism by the National Action Committee on AIDS (NACA), the Society for Family Health (SFH) and other HIV/AIDS NGOs who have all advertised condom use on billboards and in print and broadcast media as part of their prevention efforts. [4]   These organisations criticized APCON's underlying assumption that the advertisement of condoms promotes promiscuity among youths.

Putting cultural and religious sentiments about condoms above the right to information especially life-saving information that would enable people make better and well-enlightened choices about their lives, violates Art 8 of the African Charter of Human and Peoples Right as well as Art 13 of the International Covenant on Economic Social and Cultural Rights which guarantee the right to education and information.   These right should not be seen as a privilege; rather, it is a right exercisable by all including young adults. [5]   Although, the Nigerian Constitution does not expressly provide for the rights stated above, the Constitution however guarantees Art 19 of International Covenant Civil and Political Rights, which states that 'Everyone shall have the right to freedom of expression; the right include freedom to seek, receive and impart information and ideas of all kinds, regardless of frontiers, either orally, in writing or in print, in form of art, or through any other choice media.' By cracking down on advertisement of condom rather than seeing it as public health information tool, APCON undermines the obligation undertaken by Nigerian government to protect and promote the right to information.

More so, the exponential rate at which HIV/AIDS is growing in Nigeria does not morally justify any sanction against the advertisement of condoms, irrespective of where it advertised; near religious centers, schools, market place, hospital,   or even on radio and television. From a seroprevalence rate of 1.8 percent in 1991, HIV/AIDS epidemic increased by 5.8 percent in 2001, 5.4 percent in 2003, and currently an estimate of 6.1 million Nigerian are said to be carriers. [6]  Barriers on the dissemination of information about HIV/AIDS preventive method can only spell greater doom for the country; it is therefore imperative that APCON reviews the proposed restrictive code on the advertisement of condom.

Until, APCON and the supporter of propose code can come up with some surveillance or tracking device to monitor the sexual activities of youths all over the 36 states of Nigeria, it would be most fallacious to think that curbing the massive campaign for the use of condom would automatically stop young people from engaging in risky sexual behaviour. In fact, such directive may fuel secrecy about the reality of HIV/AIDS, thus remotely inciting people to engage in unprotected sex. Another issue that must be factored into tug-of-war between advocates for or against the advertisement of condoms is that most people do not know and are unwilling to go for HIV/AIDS testing, meaning that while the exact number of HIV positive people may never be conclusively known, it may also be impossible to track down new incidence of transmission. Hence, the only feasible strategy of curbing the spread of the disease would be to give the 'agency' back to people by feeding them with adequate information about HIV/AIDS preventive measures, such as voluntary counseling and testing, prompt treatment of sexually transmitted infections, strategies to prevent mother-to child transmission of HIV, use of condoms e.t.c

Without doubt, encouraging abstinence among youth and fidelity between married couples is important.  However, from a public health standpoint; consistent and correct condom use has been proven to be the only effective method for preventing HIV infection in sexually active people; a category which many Nigeria youth belongs.  It may be argued that many youths in Nigeria can learn about HIV/AIDS prevention in schools, nonetheless we must not overlook the fact that television, radio and bill boards' adverts in public places may remain the only means of reaching the more than 10 percent out-of-school youths in the country. The out-of-school youths do have a right to information and prevention education about HIV/AIDS, their rights must also be respected and taken into consideration by APCON.  Together with other strategies, notable successes recorded by Uganda and Senegal in combating HIV/AIDS pandemic has been attributed to the expansive campaigns for the use of condoms, [7] Nigeria can take a cue from these two countries.  

Curtailing promiscuity can only come from a change in social behaviour not from sanctioning the advertisement of condoms in public places or from projecting it solely as medical device. Healthy socio-sexual conduct begins with re-orienting the entire society through appropriate information and through addressing other socio-economic factors that fosters risky-sexual attitudes amongst students, out-of-school youths, and all adults in general. The socio-economic component of sexuality is a long-term goal that cannot be achieved by reduction in the campaign of condom, combating poverty, income inequality, unemployment, education , e.t.c are salient issues to consider when thinking about reducing promiscuity or other unacceptable sexual conduct.

Recommendations
For a more comprehensive approach to combating HIV/AIDS pandemic in Nigeria, I   recommend that the Nigerian government should assist in repealing laws that serve as impediments to or censorship on condom advertisement.
 
In conjunction with NACA, HIV/AIDS activists, advertising agencies and APCON should draft a national strategy plan for increasing information about HIV/AIDS, and such information should emphasize health hazards of unprotected sex, modes of transmission of HIV/AIDS/ STDS and other sexually transmitted disease, including feasible protection methods.  

APCON should have a consultative meeting with NACA, SFH and other HIV/AIDS activist organisations in order to come up with more effective strategies of creating HIV/AIDS awareness without unintentionally fuelling secrecy about available preventive measures.

The use of the mass media is imperative for public education. Therefore, government should encourage the dissemination of information about HIV/AIDS through pamphlets, posters, newspapers, magazines, books, instructions on condom packaging, films, plays, and so forth.

NGOs should be more involved in community education programs on HIV/AIDS, which should include messages in vernacular. Also special awareness program targeting adolescent and youths should be initiated; such program should be tailored towards training university students, secondary school students as well as youths outside formal school system.

With increasing efforts on awareness and education, increasing access to ARV for those living with disease should not be neglected. Both must go hand-in-hand in order to effectively curb spread of disease and to demystify the various myths about HIV/AIDS.

[1] HIV/AIDS and Human Rights in Nigeria , Background Paper for HIV/AIDS Policy Review in Nigeria prepared by the Center for the Right to Health for Policy Project. 2003.

[2] http://www.irinnews.org/AIDSreport.asp?ReportID=5807&SelectRegion=West_Africa&SelectCountry=NIGERIA  
[3] Id   
[4] Id
[5] HIV/AIDS and Human Rights in Nigeria , Background Paper for HIV/AIDS Policy Review in Nigeria prepared by the Center for the Right to Health for Policy Project.

[6] UNAIDS 2004 Report on the Global AIDS Epidemic Fact sheets
[7] http://www.salaam.co.uk/themeofthemonth/october02_index.php?l=4

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