THE CONSEQUENCES OF INEQUALITY: REFLECTIONS ON HIV

The realities of HIV spread and concentration across Nigeria are largely representative of the different forms and intersections of oppression and discrimination as they exist within and across the country. The statistics on HIV prevalence across demographics bear evidence to this.While the national prevalence of HIV in nigeria is at 1.4%, the prevalence and impacts of HIV are much higher in different groups of vulnerable persons that exist at the intersections of different forms of violence and oppression. 25% prevalence rate among Men who have Sex with Men, 16.7% among Sex Workers, 28.8% among Trans people. The prevalence rate amongst women (1.8%) is two times the rate for men (0.9%) and young children aged 0-14 account for more than one-third of all deaths due to AIDS in the country. These show that HIV prevalence is not neutral, rather that it is informed by sexism, homophobia, gender-phobia, ageism, classism, ableism, and the host of other oppressive systems and ideas that are prevalent in Nigeria.In the light of these realities, it must be said that no initiative directed towards HIV programming and control can be complete if it fails to recognise these systems and the way that they impact HIV outcomes across demographics. To effectively address the problem of HIV in Nigeria, we must address the problems of discrimination and oppression and the ways that they effect inequality in the lives of people and in their health outcomes.At CHEVS, we acknowledge the centrality of health to enjoying a dignified life worthy of human living. For this reason, improving access to healthcare and the social determinants of health forms a core part of our advocacy strategy. We do this by challenging the ideas and belief systems that allow for discrimination and violence, and impact on the health and welfare of our target communities. Health is a social justice as well as a human rights issue. To address health problems, we have to address human rights and social justice shortcomings wherever they exist in society. The failure to do this impacts on availability, accessibility, affordability, and adaptability of healthcare generally, and on HIV care and intervention efforts specifically.In recent years, Nigeria, and indeed, the world has only been able to record unequal success on HIV targets, with failures or shortcomings being focused amongst less developed nations and minority populations. The result of this has been a general failure on meeting HIV targets, more infections, and more AIDS related deaths. In Nigeria, for example, while ART coverage for the general adult population (>15) is 96%, it lies at 31% for children (0-14), 23.7% for sex workers, 26.3% for MSM, 19.5% for transgender persons, and 25% for PWUDs.The theme for the World AIDS Day 2022, EQUALIZE! aims to draw attention to the inequities and inequalities across societies around the world that hold back progress on HIV and other healthcare problems. CHEVS, in the spirit of this theme, and in recognition of the social realities that we and our right-holder communities live under, also joins her voice to issue a call for concerted efforts by all stakeholders, including government, civil society, business corporations, private organisations and private individuals, to work together to fight against entrenched social systems and institutions that embody and perpetuate inequalities, and to improve HIV response across  different areas. We must work to reform and repeal harmful laws and policies, challenge harmful social ideas and beliefs, improve education and information, increase access to HIV healthcare services, eradicate stigma and discrimination, and get communities involved in strategies and processes directed towards addressing problems particular and unique to their experiences and realities. There is a duty on us all to work for a healthier, more inclusive, and more equal world for ourselves, and for posterity. Let us `EQUALIZE!