Lagos, Nigeria – When Andrew* first discovered he was HIV-positive in January this 12 months, he suffered a fleeting sense of paralysis, fearing his life was about to vary ceaselessly.
At 27, it was one of many issues he dreaded as a homosexual man who was nonetheless within the closet. Even throughout the Nigerian LGBT group, HIV discrimination is rife and Andrew observed nobody would reply to him on the courting apps he used when he modified his standing.
Within the weeks after his analysis, he developed a routine to take care of the sickness: religiously taking his HIV remedy and practising celibacy.
Andrew is a software program developer who views the world by a prism of codes and applications, and because the coronavirus pandemic turned very actual, with Nigeria confirming its first case of the contagion in February, he felt uneasy.
The hysteria on the web, fear-mongering, and the next government-enforced lockdown in Lagos drove him to examine his stash of HIV remedy, or antiretroviral (ARV) medication. Andrew began a six-month remedy schedule in January – one 300mg pill taken every day to decrease the presence of the virus in his physique. With half the batch already taken, he realised he had sufficient to final him till June.
However Andrew was nonetheless gripped with anxiousness. “I am imagined to get examined after six months to examine if I am detectable. I do not assume I am detectable but, and with coronavirus on the town, what if I contract it with the state of my immune system?” he puzzled.
Detectable refers to Andrew’s viral load, or the presence of the virus in his physique.
A difficult well being system
Restricted analysis has indicated that folks with HIV might not face any better danger of an infection from the novel coronavirus, so long as they adhere to their prescribed antiretroviral remedy and should not in any other case immunocompromised, in accordance with the Facilities for Illness Management and Prevention (CDC).
Andrew doesn’t have medical health insurance, so he depends on free HIV remedy from healthcare centres which are LGBT-inclusive. With the lockdown rolling on and ushering a recent wave of unrest, he’s now counting on digital consultations together with his physician – WhatsApp, video calls – which has dissipated his anxiousness to an extent.
Not solely is the coronavirus pandemic exposing the decaying state of public well being infrastructure in Nigeria, it is usually exhibiting how Nigeria’s LGBT inhabitants has restricted entry to medical doctors that present secure, affirming areas. This stems from the truth that Nigeria stays one of the crucial homophobic nations on this planet, rendering LGBT Nigerians targets of discrimination and abuse.
Since 2014, there was a regulation in place which criminalises same-sex marriage and public shows of affection between homosexual folks. There aren’t any official rights or protections from discrimination primarily based on sexual orientation – which makes it tough for LGBT Nigerians to hunt assist from public companies.
The lockdown in Lagos additionally got here with pockets of militarisation within the state and elsewhere – troopers and safety forces implementing stay-at-home orders even when it means resorting to intimidation and violence.
As such, LGBT Nigerians attempting to entry HIV remedy are confronted with the added problem of navigating doubtlessly hostile forces.
In March, Ebuka*, a 26-year-old bisexual man, agreed to an interview at a pizza place earlier than the lockdown started.
Ebuka examined constructive for HIV in November 2018. His psychological well being had been blighted by cycles of despair and one traumatic, self-harm episode. However relocating from Abuja to Lagos the next 12 months to start out a brand new job in digital promoting had lifted him from the mist, and he discovered some semblance of stability and readability.
On the pizza place, Ebuka revealed that his present batch of ARV medication was practically depleted and he wanted to acquire one other prescription refill quickly.
“April,” he mentioned, after I requested about his subsequent clinic appointment. Ebuka and Andrew have barely totally different HIV remedy regimens. Since he has already achieved undetectable standing, Ebuka’s HIV remedy is available in a three-month batch.
Any disruption in remedy may go away his immune system susceptible to opportunistic infections just like the coronavirus.
The subsequent time I heard from Ebuka, it was the second week of lockdown. He described how he had skilled police harassment, after being profiled as “homosexual”, whereas driving to the clinic to acquire his subsequent batch of HIV remedy, which ought to final him one other three months. He fears the police greater than HIV or coronavirus, he defined.
Distant well being options
The clinic Ebuka was heading to in Lagos was by no means overcrowded, is sectioned into consultancy, pharmacy and blood labs, and helmed by an environment friendly workers working in shifts. It is without doubt one of the few areas in Lagos the place LGBT Nigerians with out well being protection can entry free HIV remedy in a discrimination-free ambiance, the place their sexual historical past and habits don’t endure judgemental scrutiny.
In distinction, in public well being environments, many LGBT sufferers say homophobia is deeply entrenched they usually face an unwelcoming ambiance.
The centre, which didn’t need to be recognized on this report, has since complied with the federal government lockdown. A medical consultant instructed Al Jazeera that it opens on choose days for its well being staff to dispense HIV healthcare in order that sufferers like Ebuka can receive their life-saving ARV medication.
Andrew bought his HIV remedy from The Initiative for Equal Rights (TIERS), a non-profit organisation that has steadfastly championed LGBT inclusion and advocacy since its inception. TIERS additionally closed due to the lockdown, however is attempting to make sure that susceptible LGBT communities should not reduce off from accessing well being companies.
“We closed our bodily places of work since 18 March, however medical companies have been working just about since then,” Xeenarh Mohammed, govt director of the centre, defined by cellphone. “We have now ARV pick-up to purchasers …. In instances the place the remedy must be dispatched, the shopper might be liable for sending a dispatch rider for pick-up. That means, confidentiality is maintained because the rider is introduced on to them. Drugs are packed discreetly.”
Olumide Makanjuola, a sexual well being and rights activist, is most involved in regards to the impact of the outbreak and lockdown on probably the most susceptible. “I consider individuals who’re residing with HIV in communities, like LGBTIQ, intercourse staff and Injecting Drug Customers (IDUs) whose entry to well being is generally by area of interest, non-governmental organisations,” he mentioned over electronic mail.
Afterward the cellphone, Makanjuola expressed different considerations: “There might be a whole lot of anxiousness and the potential of drug unavailability at centres attributable to supply delay and different logistics-related points.” Makanjuola was fast to level out that this isn’t a present actuality, however a projection if the lockdown persists past three months.
Antiretroviral medication are imported and a part of numerous HIV prevention and remedy tasks funded by native and worldwide donors, working with well being areas like TIERS to succeed in key goal populations like males who’ve intercourse with males (MSM) and others.
Though Nigeria has closed its air borders to decelerate the unfold of coronavirus, important flights purveying medical provides and medicines can nonetheless enter the nation, however not with out delays from donors as they’re additionally navigating lockdowns in their very own terrains.
These centres in Nigeria are actually confronted with native logistics points since there’s a restriction of motion, with taxi-hailing companies barely operational.
However the ease in lockdown in the meanwhile, ranging from Could 4, is a welcome improvement and will assist as many LGBT Nigerians with HIV entry healthcare, with out the preliminary obstacles.
Regardless of budgetary allocations, Nigeria’s healthcare system is severely stunted by political corruption. Congestion in public well being amenities, and lack of kit, medication and medical doctors have created vacuums the place non-governmental organisations have gotten a part of the ecosystem, assembly the well being wants of various communities and sub-groups.
The LGBT group in Nigeria exists as a heterogenous group, the place interactions happen in discrete bubbles throughout digital platforms. However amid the coronavirus pandemic, members are forging solidarity and coping with their communal anxieties by digital hangouts.
Andrew says he has been serving to a number of group members with groceries and dried meals, whereas Ebuka sought out these with HIV who want remedy, to assist cowl the price of dispatch supply.
*Names have been modified to guard privateness