GHAIN Helps PLHA Reject Stigma, Find Support, and Get Involved

MARCH 2008 — Despite losing the support of his friends, wife, and children, "I did what I had to do to survive," says Ubaka Jones Nwabuokei. Like many thousands of Nigerians, Nwabuokei, 48, is successfully challenging the rejection, stigma, and discrimination that often result when they reveal their HIV-positive status to those closest to them.

Nwabuokei is a welding engineer and construction site supervisor in the Nigerian capital, Abuja. About three years ago, he began having digestive problems, which progressed to the point where he could not regularly eat. He lost so much weight "you wouldn't have recognized me" and developed an ulcer on his side that would not heal. Finally, he said, "it was like I had a breakdown in my system."

In late 2006, staff at the government-run Wuse General Hospital encouraged him and his wife to get tested for HIV, but they were reluctant. Finally, his elder brother, a doctor, convinced Nwabuokei to get tested. When the counselor asked if she could give him the results with his wife present, he said, "Yes, of course, she's my wife!" Learning he was HIV-positive was when "the drama stage began," Nwabuokei says. Nwabuokei's wife seemed shocked and, after a brief discussion, "she packed up and left," taking their five young children. They are now in the midst of divorce proceedings.

Counseling and Testing Targets Reached Two Years Early
The government-run hospital where Nwabuokei was tested receives support from the Global HIV/AIDS Initiative Nigeria (GHAIN) project, which is funded by the President's Emergency Fund for AIDS Relief through USAID and implemented by FHI. By October 2007, GHAIN-supported facilities and implementing agencies had counseled and tested over 1 million people, 25 percent of the total counseled and tested in Nigeria and an achievement that came two years earlier than targeted.

Upon learning his status, "I was really down," Nwabuokei said, "but I started looking for solutions, drugs, and treatment." His post-test counselor, Mrs Hart, suggested he start by seeing Wuse General Hospital's nutritionist. In addition to learning how to maintain his health through good nutrition, he was also educated on what HIV is and the importance of adhering to the antiretroviral drug regimen for life. Two years later, Nwabuokei's CD4 count has increased from 210 to 450, he appears fit and healthy, and he has returned to work as an independent contractor.

Supporting Those Who Test Positive
The two places Nwabuokei has found most accepting of his status are in his work as a support-group leader at the hospital and in his church. On the first Saturday of each month, he leads a support group of 120 other HIV-positive people in discussions on all aspects of the disease. "Since we've been through it, we can help people get through most illnesses," he says. He also dispenses advice on adherence, side effects from the drugs, and—as funds allow—distributes a small food supplement and water purification powder to group members in greatest need.

GHAIN's support has also allowed Nwabuokei to get training in referral coordination. "When people move from point A to point B, we receive them, register them, and make sure their supply of drugs is maintained." He also introduces them to the support group, and follows up on and tracks patients, including those who stop showing up to collect drugs or attend support group. "For you to help those who are sick and in need, you have to know where to get them," said Nwabuokei. He spends four to five hours every day doing this volunteer work. "I feel the need to give service and save a life. If we have a way to intervene, it's better." 

In his church, Nwabuokei's minister was immediately supportive: "How are you managing your life?" he asked, and then made sure Nwabuokei had money to get him through some rough financial times. The church has since begun its own HIV support group and supported Nwabuokei to receive training in provision of home-based and palliative care.

Nwabuokei's advice to Nigerians is that everyone should go for counseling and testing. "Being HIV-positive is not at all the end of life."

— John Engels

PHOTO: Ubaka Jones Nwabuokei is a PLHA support group leader who has been trained in referral coordination by the GHAIN Project. "I feel the need to give service and save a life," he says. (FHI/Nigeria)