CHAPTER 4 – HIV/AIDS

4.1 DEFINITIONS AND BIOLOGICAL BACKGROUND

HIV (Human Immunodeficiency Virus): a virus that attacks the immune system (CD4 cells).

AIDS (Acquired Immune Deficiency Syndrome): advanced stage of HIV infection when the immune system is severely damaged and opportunistic infections occur.

How HIV works (simple): HIV enters the bloodstream, destroys CD4 cells, weakening immune defense; without treatment, opportunistic infections and certain cancers can develop.

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4.2 MODES OF TRANSMISSION

• Unprotected sexual intercourse (heterosexual and homosexual) — the most common mode in Nigeria.
• Mother-to-child transmission (MTCT): during pregnancy, childbirth or breastfeeding.
• Sharing of contaminated needles / syringes — injecting drug use, unsafe medical injections.
• Blood transfusion with infected blood (rare now due to screening).
• Occupational exposure: needle-stick injuries among health workers (preventable).

4.3 COMMON MYTHS AND FACTS

• Myth: HIV can be transmitted by mosquito bites. Fact: No — mosquitoes do not transmit HIV.
• Myth: HIV equals immediate death. Fact: With early testing and antiretroviral therapy (ART), people live long healthy lives.
• Myth: Only certain “types” of people get HIV. Fact: Anyone can be infected if exposed.

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4.4 PREVENTION STRATEGIES

• Abstinence — avoiding sexual activity.
• Be faithful / mutual monogamy — both partners uninfected.
• Condom use — consistent and correct use lowers transmission risk.
• PMTCT (Prevention of Mother-To-Child Transmission): antenatal testing, antiretroviral prophylaxis to mother and infant, safe delivery practices and appropriate infant feeding.
• Safe injection practices — sterile needles, avoid re-use.
• Testing and early treatment: voluntary counselling and testing (VCT), routine testing at health centres.
• Education and stigma reduction.

4.5 TESTING AND TREATMENT

• HIV testing: rapid tests available at clinics, community outreaches; counselling before and after testing.
• Antiretroviral therapy (ART): suppresses viral replication, preserves immune function, reduces transmission (including to sexual partners and babies).
• Adherence to medication is critical to prevent resistance.
• Treatment as prevention: when viral load is undetectable, transmission risk is drastically reduced (U=U: undetectable = untransmutable).

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4.6 SOCIAL IMPACTS AND STIGMA

• People living with HIV (PLHIV) may face discrimination at work, school, and in families — this worsens mental health and discourages testing.
• Community support systems, anti-discrimination laws, and education reduce stigma.

4.7 NATIONAL RESPONSE AND SCHOOL ROLE (NIGERIA EXAMPLES)

• Governmental programmes for free ART in public health facilities, PMTCT programmes, and public awareness campaigns.
• Schools provide age-appropriate sex education, counselling, and referrals to health services.

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