Q & A with Prof. Lawrence Adeokun
Director, Evaluation and Operations Research
Association for Reproductive and Family Health (ARFH)
Ibadan, Nigeria

October 2002

How has HIV epidemic affected your community?

With Oyo State, Nigeria, at a prevalence rate of just under 5%, the public awareness of the epidemic is rising. Social and demographic groups are beginning to identify cases of AIDS in their midst. The medium and large-scale establishments are recording cases of AIDS death from amongst their employees. Causes of such deaths are no longer easily rationalized as natural, because there is now general recognition of some of the symptoms of AIDS. Ministries, NGO’s and the banks are examples of such establishments.

Are there any specific stories or anecdotes that stand out in your mind?

An establishment with about 100 employees has reported three incontrovertible AIDS related deaths in the course of the year 2002. This is causing some despondency among the surviving employees.

What are your fears about the epidemic in Nigeria and what are your hopes about Nigeria’s response to it?

The greatest fear is that the uneven prevalence of HIV in a country the size of Nigeria makes the programming of AIDS prevention at a national level very difficult. Different levels of prevalence tend to create different levels of prioritization of the epidemic and of the response to it. As in other large populations, it may take some high profile and sensationalized AIDS death, especially within the political class, to generate a nation-wide commitment to AIDS prevention as a major emergency.

A major hope is that with the national leadership in AIDS prevention being fostered by APIN in Abuja, the necessary commitment of the political leadership may be enlisted. Another hope is that the commitment will translate into a multi-dimensional approach to the control and management of the epidemic. The development of realistic state plan of action, of the type supported by APIN in Oyo State might be a first step to addressing the range of biomedical and biosocial aspects of the epidemic.

How has APIN impacted your project/program?

The funding from APIN on four sub-projects allowed different aspects of AIDS prevention to be addressed. The in- and out-of school youth program focused on the development of the peer education approach in a known risk group involving 85 secondary schools and the neighborhoods in which they are situated. The promotion of male involvement in dual protection in market places took AIDS prevention to the general population passing through five of the largest daily markets in Ibadan City.

The promotion of dual protection in 43 private health facilities allowed a systematic exposure to AIDS prevention counseling of women in their reproductive ages patronizing the clinics. Above all, but to a limited extent, the funding allowed the onset of a program of syndromic management of STI’s in primary health care centers. This sub-project nicely complements the awareness and dual protection activities of the other projects.

Can you describe how one could see the changes that have taken place since collaborating with APIN?

One of the tangible aspects of AIDS prevention activities has been the use of billboards as a means of communication. This medium is extremely popular for commercial advertisements but has only begun to be integrated into health promotion. A number of such billboards are now in place around schools and markets.

Some other artifacts of the project are the 2002 calendar based on the posters developed by secondary school students during their peer education training for the APIN sub-project and address book and diaries distributed to peer educators. These IEC materials are very popular with other cadres of peer educators in health facilities, markets and PHC clinics.

What can you do now in your program that you couldn’t do before?

The network of peer educators has nearly tripled as a result of the project implementation. This allows substantial increase in outreach activities on AIDS prevention. More importantly, the focus on Ibadan City made the multiplier effect of these peer educators higher than would have been the case in a statewide program.