Olanrewaju Onigbogi, M.D., Nigeria
My name is Olanrewaju Onigbogi. I work as a public health physician at the University College Hospital in Ibadan, Nigeria.
I would like to start by giving people a perspective of Nigeria. Nigeria is such a big country, and I work as a researcher in Ibadan, which is in the southwestern part of the country. Many national HIV rates aren't really correct, so the best you can have are regional rates based on work that people have actually done in their region. So I'll be talking strictly about my work around the area where I live.
The HIV situation in Nigeria: I can say it's stabilizing. It was getting worse a few years ago, but now the rates are going down. The data also show that the infection rates are going down.
However, the problems are still far from being over, because if education is not continued, people are likely to go back to high-risk behaviors. The greatest problem we have in Nigeria really is with high-risk behaviors, specifically among men who have sex with men, because many of them do not have access to HIV education. When they do, they don't have the resources to get condoms and lubes.
Most prevention services just target providing condoms, but with men who have sex with men, they actually need lubricants [lubes]. The lubes are still pretty expensive. That's the greatest problem I think we're having now with prevention services, especially with regards to MSM.
A few years ago, it was a lot worse. It was really difficult to get people to come out to say they were in the lesbian/gay/bisexual/transvestite community. Any kind of sexual orientation that was different from heterosexual, it was almost impossible to come out, to identify with it.
Initially it was like hardened resistance. It's gone to cynicism and discrimination. Like, OK, that's them, but we keep them at a distance. The laws are clear about it. The laws are still very strict and rigid. Sometimes people could go to prison for as long as 10 or 15 years. Because of the laws, the policemen can actually pick up people and harass them, even if they're not really keen about enforcing the laws. That's the other issue. The laws criminalize MSM, but enforcement is not really done. It's more harassment. That's a problem.
Like I said, it was a lot worse a few years ago. Now many more people are coming out. The government probably has greater problems to battle with, but the greatest problem people have is with their immediate families -- the parents and the siblings. That's the greatest problem they have. The government has other problems -- many other problems -- but the greatest problem that people really have is with their own families. That's where the discrimination really starts.