THREE WOMEN, THREE BATTLES, A COMMON FOE Fighting HIV in Africa's Most Populous Country

Both HIV incidence and AIDS mortality have fallen in Nigeria and elsewhere over the past decade with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Credited with saving 25 million lives, PEPFAR is considered one of the most successful global health programs in history.

For the first time, declines in new HIV infections in sub-Saharan Africa are ahead of every other region in the world. “The biggest gains have been among adults, particularly women, and in sub-Saharan Africa, the region with the largest epidemic,” said the 2023 UNAIDS Global AIDS Update released in July.

In Nigeria, the largest sub-Saharan country by population, 1.9 million people were living with HIV as of 2018. HIV prevalence among adults aged 15-49 years fell from 3.4% in 2012 to 1.3% in 2018, the date for which the latest figures from Nigeria are available.

Chemonics works with partners in Nigeria to procure and deliver lifesaving medications, provide training to health and supply chain workers, link people to care and treatment, strengthen health systems, and expand laboratory services to reduce the country’s HIV burden. The wider availability of testing and treatment through PEPFAR has made an enormous difference, enabling people to live heathier and longer lives and prevent new HIV infections.

Below we highlight the stories of three Nigerian women* whose lives and the lives of their families have been changed by the efforts of Chemonics and its partners to fight HIV.

Globally, between 2016 and March 2024, the USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project has:

Mariam

One night last year, there was a commotion in Mariam’s neighborhood. Someone had found an abandoned baby, lying on the ground. Police arrived and decided to take the baby to the hospital. Mariam followed them. The infant boy was considered high risk for HIV because he was premature and orphaned. Mariam, a mother of four who works in a daycare, could not get him out of her mind. “I fell in love with the baby,” she said.

She visited him regularly in intensive care, where he stayed for 28 days before being transferred to a nearby orphanage. Mariam followed him there as well and convinced the administrators to let her adopt him. Although the baby received HIV prophylaxis, there was still a small chance that he could go on to develop HIV. Newborns are at an increased risk for acquiring HIV if they are exposed to HIV during birth or breastfeeding or if their birth mothers do not receive antiretrovirals (ARVs) during pregnancy.

Despite the risk that the baby could develop HIV, it didn’t matter to Mariam. She was willing to provide all the care and medicine that he needed. In her eyes, it was simple: “He has a right to live.”

Learn more about our work to prevent mother-to-child transmission of HIV through the USAID Nigeria Strategic HIV/AIDS and TB Response Program.

Top row (from left to right): (1) Clients wait to receive medication from a clinic pharmacy. (2) HIV medication. Bottom row (from left to right): (3) Mariam holds her adopted baby boy. (4) A health worker provides medication to Mariam for her baby.

Sonya

Sonya and Olu had been married for a month and she was so happy in their new life together. Then she began to develop a rash on her thighs. Having no idea what could have caused it, Sonya sought help at a clinic. To her astonishment, health workers advised that she get an HIV test. It was positive. “I felt like the world was about to come to an end,” she said.

But her husband’s reaction gave her added strength. He said, “There is nothing that God cannot do.”

Olu has remained HIV negative for their entire 17-year marriage because Sonya has consistently taken her ARVs and been virally suppressed. Their two children, now teens, are also HIV negative because Sonya took her medication during pregnancy.

Sonya used to go to the hospital once a month to retrieve her medication, but she’s relieved now to go only every six months, thanks to multi-month dispensing, which saves her both time and money and gives clinicians more time with other patients in need.

Sonya has remained strong and healthy and is thankful for her supportive spouse. “I married the bone of my bone and the flesh of my flesh,” she said. “I did not have to go through that trauma of having to fight for my marriage and fight for my home.”

Learn more about how we support procurement for lifesaving antiretrovirals through GHSC-PSM.

Top row (from left to right): (1) Lab workers conducting analysis. (2) A health care worker counsels Sonya. Bottom row (from left to right): (3) A client reviews her medication. (4) A client undergoes testing.

Yvonne

Yvonne has been an HIV counselor for the past 16 years and has given guidance to thousands of people living with HIV. But she was not always in a state of mind to be able to help others.

“I felt pained when I learned of my HIV status and I thought of so many things, even committing suicide,” she said. “Emotionally I used to break down and it would not be good. My children would not be well taken care of because I wasn’t able to give them direction. I couldn’t work and would stay home.”

Yvonne said she has been consistently taking her medication and has been well for the past five years and her three children are now in school. Only her firstborn is infected with HIV. She said that while social stigma has diminished, self-stigma remains common because people still fear others will shun them. Some will travel to another state to have their viral load tested and to pick up their medication to avoid seeing someone they know.

“I feel happy that my immediate environment is not aware,” said Yvonne. “I’m able to carry on my normal life.”

Learn more about how we are helping to bring laboratory testing services closer to clients through GHSC-PSM.

Top row (from left to right): (1) Reviewing lab samples. (2) HIV medication. Bottom row (from left to right): (3) Yvonne walks across the grounds of the clinic where she works as an HIV counselor. (4) Yvonne working at her desk

For more information on Chemonics’ HIV/AIDS work, see our 2023 World AIDS Day experience.

*Names have been changed to protect privacy.

Cover photo: A health worker speaks to a patient about her medication.

Photo Two: Patients wait outside a lab to be tested.

Photo Three: Warehouse employees inspect boxes of HIV test kits.

Story by Cindy Shiner, Chemonics. Photos by Toyin Adedokun and Cindy Shiner for Chemonics. Page created by Chris Norman, Chemonics.