“AIDS is now the leading cause of death in military and police forces in some African countries, accounting for more than half of in-service mortality,” write Ugboga Nwokoji and Ademola Ajuwon in the Open Access journal BMC Public Health today.
They believe that secrecy about AIDS-related deaths, and multiple sex partnering in the Nigerian navy could be helping to fuel the HIV epidemic in Nigeria, Africa’s most populated country.
Their survey of 480 Nigerian naval personnel revealed that the naval authorities are secretive about AIDS-related deaths. One naval officer insisted, “although we often hear that an officer has died of malaria or of tuberculosis, we never hear about a death from AIDS.”
“Until AIDS-related deaths are discussed openly, naval personnel will continue to deny the existence of the virus and participate in risky behaviours,” say the researchers, from the Nigerian Red Cross Society and the University of Ibadan. They are now calling for a targeted educational program to expose the risks that sailors face from indulging in unsafe sex.
Around a third of the sailors questioned had had sex with a female sex worker, and 41% of these had not used a condom on their last visit. Shockingly, those that were married were around four times less likely to use a condom than those that were single.
As these sailors live with and interact freely with civilians they are a potential bridging group for disseminating HIV into the larger population. The researchers believe that initiatives to prevent this high-risk population from contracting HIV are one of the most realistic ways of controlling further spread of the disease across Nigeria.
“The military authorities need to promote use of condoms more vigorously”, say Nwokoji and Ajuwon. Condoms should be available to all who need them. One officer claimed that, “the naval tradition is that if you are going ashore, you are issued condoms and there is no ration about this, however, due to funding constraints this is no longer practiced.”