Concord Times (Freetown)
Mariama Kandeh
12 November 2008
With less than a month to go before this year's World AIDS Day, events to commemorate the day are on the way all over the world.
The 20th annual World AIDS Day celebration that will take place on December 1 will focus on 'leadership', the theme set by the World AIDS Campaign under the five-year slogan "Stop AIDS! Keep the Promise".
World AIDS Day is a day when the world comes together with an effort of raising awareness about HIV and to express global solidarity with people living with HIV. The day also provides a global opportunity to urge governments and leaders for all promises on AIDS to be kept as well as an opportunity to demonstrate commitment and action on AIDS.
In designating 'leadership' as the World AIDS Day theme for the next two years (2008 - 2010), the campaign will highlight the political leadership needed to fulfil commitments made in response to combating the pandemic particularly the promise of universal access to treatment, prevention, care and support.
In Sierra Leone, the latest national zero prevalence survey of the disease showed a relatively low 1.53% infection rate. Despite this positive result, Patrick Childress in his work the 'Uncertain future of HIV/AIDS in Sierra Leone ' in August 2008 indicated some behavioural and social factors which depicted a bleak future for Sierra Leoneans with regards the tendency of the spread of the epidemic.
According to the 2007 statistics, over 42 million people are living with HIV and 74% of that exists in sub-Saharan Africa. There is a high tendency of that figure erupting due to the currently credit crunch hitting Africa , where the poor is becoming extremely poorer, commercial sex workers on the increase as well as wars and natural disasters; thus indicating a greater chance for the spread of the pandemic.
Report also shows that there are 14,000 new infections every day with 95% of that number occurring in developing countries. With a population of just 5 million people, Sierra Leone still has a low prevalence but needs urgent and ardent measures to control it by keeping a watchful eye on the rate of prostitution. It is an open secret that the rate of prostitution in Sierra Leone is skyrocketing with the increase in the poor standard of living, less job opportunities, and the lack of social amenities despite the so called decentralization process that has been on course for the last four years now.
A 1997 survey revealed a staggering 70.6% of commercial sex workers in Freetown were HIV positive. How ever, this number may have exploded significantly, spreading to remote villages where culture prevented sex before marriage long years ago and the non-existence of prostitution. With the advent of the 11 years carnage in Sierra Leone and the mobility of NGO workers and peace keepers ,it is evident that the disease may have spread among sex workers even the more. Another behavioural factor that has aided the spread of the disease further is early sexual debut.. This has become very common in Sierra Leone and analysts believe is an aftermath of the war.
During the war many young people were forced into having very early sex, especially girls that were taken as wives by rebel commanders. Also, the culture of early and forceful marriage paved the way for early sexual debut. A recent survey also pointed out that 64% of teenagers in Sierra Leone have had sexual intercourse which, by no doubt, depicts a serious concern considering the fact that in a country like South Africa where high rate of the epidemic has been registered, only 17% of the teenagers in that country have had sexual intercourse.
A United Nation World population prospect report ranked Sierra Leone 9th in the world for the highest number of children a woman was likely to have during her child bearing age. However, experts normally link high fertility rate to high number of sexual act. If this is the case, it is clear that the lack of social amenities especially in the provinces which form the bulk of Sierra Leone 's population may be one of the factors for this high fertility rate.
It is evident that people in the provinces seek sex for pleasure after farm work as the only means of entertainment. They lack power supply let alone talk of television facility and cinemas et al. Where do people expect these vulnerable villagers to get fun when they are generally living in abject poverty which forms a part of human life? Sex of course generates happiness for them.
Conversely, it is a fact that homosexuality is being practiced in Sierra Leone both among women and men but society has made it a taboo to even discuss it. The stigma attached to it has made it impossible for gay people to come out and tell their sexual habits. It is difficult for HIV campaigners to reach this particular set of people in the country.
Homosexuals have a higher propensity of spreading the disease. It has been proven that there is a high risk of contracting HIV through anal sex. However, with the raping and killing of gay rights activist Fanny Ann eddy in 2004, the task has become tedious as it will be impossible to estimate the number of gay people in the country and at the same time reaching them with HIV/interventions have proven impossible. Another appalling factor is the lack of access to medical facilities. This will subsequently lead to a further increase in the spread of HIV in Sierra Leone . Apparently, there will come a time when the available medical facility will not be able to service the increased number of new infections. It will pose a serious threat to the free service of antiretroviral (ARVs) therapy especially its availability as the number grows. Considering the fact that people are poor in Sierra Leone , compounded by the fact that ARVs are very expensive, the developing world would be hard hit or a case of do or die.
Newspaper report has shown that over 260,000 people nationwide have been tested so far for the disease while 4,017 patients were already receiving treatment for the disease in the country. As stakeholders in Sierra Leone plan for this year's world AIDS day celebration, there is a need for them to take robust actions at this very important period in the history of the endemic in Sierra Leone so as to prevent a further increase that will pose a further threat to development in Sierra Leone .
An increase of HIV in Sierra Leone will surely have adverse effect on development agenda especially for important targets such as food security and human resource base.
Action on the endemic now means curbing the spread of a devastating illness and saving the lives of poor people who are uncertain of a better future.
Finally, the government needs to prioritise the fight against HIV by bringing out practical policies that are achievable and at the same time protect both those infected and the non infected people. There is also a need for policies that will shelve away the stigma attached not only to having HIV but also telling one's sexual choice. I believe the above steps are a stepping stone towards a happy life for thousands of Sierra Leoneans.
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