Nigeria’s HIV response should move beyond viral suppression to tackle other health risks that could undermine the long-term wellbeing of people living with the virus, a Nigerian HIV/AIDS researcher, Pharm. Melody Okereke, has said.
Okereke called for tobacco screening, counselling and harm-reduction strategies to be integrated into routine HIV services, particularly at primary healthcare centres, saying such an approach could help improve the quality of life of people living with HIV.
In a recent article shared with Western Post, the pharmacist noted that advances in HIV treatment had transformed the condition, enabling more people to access antiretroviral therapy, achieve viral suppression and live significantly longer.
However, he warned that controlling HIV should no longer be viewed as the sole objective of care, particularly as patients live longer and become increasingly exposed to other chronic health conditions.
According to him, tobacco use remains an overlooked health challenge among people living with HIV.
He noted that some patients who have achieved good HIV treatment outcomes still experience persistent cough, breathing difficulties and other respiratory symptoms that may be associated with prolonged tobacco use.
An overlooked issue in HIV clinics
Okereke said tobacco use was not routinely addressed during many HIV consultations, not necessarily because healthcare workers did not recognise its importance, but because many health facilities lacked the tools, training and resources needed to manage tobacco dependence as part of comprehensive HIV care.
He argued that integrating tobacco-related services into existing HIV programmes would not necessarily require the creation of a separate healthcare structure.
“Integrating tobacco screening and counselling into HIV services does not mean creating another complicated programme. It means recognising that patients come to us with multiple health challenges, not just one diagnosis,” Okereke said.
He said the evolving nature of HIV care required health systems to adopt a broader approach that takes account of the health challenges patients may face as they grow older.
These challenges, he noted, include respiratory and cardiovascular diseases, cancers and mental health conditions.
Focus on long-term wellbeing
The researcher said the increasing life expectancy of people living with HIV meant healthcare providers must pay greater attention to factors that could affect patients’ long-term health beyond HIV itself.
Tobacco use, he suggested, should therefore be routinely assessed during HIV consultations, with patients given appropriate information and support to reduce or stop their tobacco consumption.
He acknowledged that nicotine dependence could make quitting difficult for some patients.
While complete tobacco cessation remains the best option, Okereke said healthcare workers should offer structured counselling and other forms of support to patients who struggle to quit rather than leaving them without assistance.
Call for action at primary healthcare level
Okereke urged health authorities to incorporate tobacco screening and counselling into existing HIV services, particularly at primary healthcare centres where many patients receive routine care.
He also advocated the use of tobacco harm-reduction strategies as an additional avenue for engaging patients who find it difficult to quit completely.
The approach, he said, could help healthcare workers maintain conversations with patients about tobacco use while supporting them towards healthier choices.
For Nigeria’s HIV programme, the call comes against the backdrop of a changing healthcare landscape in which improved HIV treatment has allowed more people living with the virus to survive and age into periods of life where other chronic diseases become increasingly important.
Okereke stressed that comprehensive HIV care should consequently address the whole health needs of patients rather than focusing exclusively on HIV treatment.
Integrating tobacco screening, counselling and appropriate cessation or harm-reduction support into routine HIV services, he said, would provide an opportunity to identify tobacco use earlier, support patients who want to quit and ultimately promote healthier, longer lives among people living with HIV.