I am writing this from the back of a vehicle in Nigeria. I’m in Lagos, the biggest city in Africa and home to 21 million people. New Africa. A so-called mega city. Vibrant, ambitious, tenacious, captivating. And becoming increasingly liberal as the trappings of our globalised world take hold? Not where it really matters, no.
Today I was told of a dress code for women who attend a business skills development course. Encouraged into business and championed as role models for a modernising country? Yes, but as just as long they don’t do it in trousers, v neck tops or skirts that end above the knee. But worse than that, sexual freedom is being curtailed.
In 2014, the Nigerian government increased the punishment for homosexuality to 14 years in jail. Anyone ‘assisting couples’ may face a 10 year sentence. In 2010, just 18% of men who have sex with men were reached with HIV prevention services. They do not access the services they need to manage their sexual health out of fear for their freedom. The result? In 2007, 13.5% of men who have sex with men were living with HIV. By 2016, that had risen to 23%. It’s not only men who have sex with men whose health is being failed by the Nigerian government. They are falling short on recommended target for testing, treatment and counselling services for the whole population. The country has second largest HIV epidemic in the world.
Meanwhile, on Sunday, in my hotel my room in Lagos, I exercised a privilege many Nigerians don’t have. I took an HIV test. The kit came courtesy of Freedom Shop and was given to me at Eroticon. The whole process took about half an hour in total: a few minutes reading the blurb that came with the test, five or ten minutes rereading The Other Livvy and Emmeline Peach’s great reviews, an embarrassing number of minutes summoning up the courage to use the lancet and then 15 minutes for the test to progress. It was easy, discreet and, actually, quite an empowering experience. It may sound odd to say I enjoyed the process, but I did. I was in control.
I live in the UK. Here we can pick up a kit like the Bio-Sure HIV Self Test for under £30 and test at a time that suits us. If we have a little more time and are not anxious about visiting a clinic we can test for free. Home testing kits are free for high risk groups. Yet, despite the ease with which we can access testing and a low prevalence rate, the UK still needs to make progress. Here, new diagnoses are almost double the average for Western Europe, it is estimated that 13,500 are unaware of their positive status and 40% of those diagnosed positive receive a late diagnosis. The National Survey of Sexual Attitudes and Lifestyles found that just 14% of those who identified as high risk had taken a test recently.
It is easy to think that the world has got a handle on the HIV pandemic. Comparatively speaking it has. The first time I worked in Africa, in 2003, I was visiting communities where almost the entire population of working age adults had died and the majority of households were headed by grandparents or children. Then, fewer than 200,000 people around the world were accessing treatment, now 19.5 million people receive antiretroviral (ARV) treatment. An HIV positive person on ARVs who has had an undetectable viral load for more than six months can’t pass it on.
But there is still a long way to go. 17.2 million HIV+ people still aren’t getting treatment. The rate of HIV infection hasn’t declined amongst adults since 2010. There were 1.8 million new cases in 2016. We all have a role to play in tackling HIV, by taking care of our own sexual health, especially if we are lucky enough to live in a country where stigma is (relatively) low and testing and treatment services are free, by staying up to date on the facts and testing our knowledge and joining campaigns where our voice can make a difference.
Happy World AIDS Day!
For self-testing kits plus a whole lot of other useful stuff for staying safe and heathy visit https://www.freedoms-shop.com/