Nigeria: PrEP – Preventing HIV infection Many Nigerians need, do not know and can not afford


Joan, the lady in the late twenties, is having sex with people she hardly knows; something she has never met before.

Joan lives with her friends in Kubwa, a suburb of the Federal Capital Territory (FCT).

She said she had no choice but to start her life as a sex worker after losing her parents at the age of 18.

For the past six years, Joan says she has had sexual intercourse with more than 100 men at various locations in the country.

She said she travels several times to meet some customers on the basis of their request.

As a sex worker, Joan does not know what prophylaxis is from Exposure (PrEP), and the only method she knows is the use of a condom.

However, she said that the condom is not reliable, as it sometimes heals some "big" SPIs (sexually transmitted infections).

"I always use condoms, but the truth is that condoms have their own mind, so they break apart when they want, and I can not control it.

"I sleep every day with different men, so I know I'm in danger of getting sexually transmitted infections every time I get sex," she said.

Illegal but successful

Although sexual trafficking in Nigeria is illegal, there is no doubt that the trade continues to grow.

Like Joan, many PREMIUM TIMES sex workers said they did not hear about PrEP or know the importance of drugs.

Gloria, a 26-year-old sex worker, insists she is not a full-time worker, as she also works as a secretary in a private company.

She lives with her brothers and sisters in an unpainted one-bedroom apartment in the Jabbi Abuja area.

"I have more sexual partners, but I do not take any drugs before or after sex, in order to prevent infections.

"I use condom when needed, but not always, because I have some partners that I trust so much. So I do not use condoms, rather than condoms," she said.


Prophylaxis from Exposure (PrEP) is the use of a pill called Truvada to prevent HIV infection in uninfected individuals.

Truvada is a combination of two antiretroviral agents (tenofovir + emtricitabine) to prevent the spread of the virus through the body.

Studies have shown that Truvada can prevent HIV infection in 90% of cases if pills are taken daily or less at the same time.

In 2014, the World Health Organization (WHO) first recommended that PrEP be offered only to men who have sex with men.

However, on the basis of further evidence of the effectiveness and acceptability of the PrEP in September 2015, the World Health Organization recommended people with a high risk of HIV infection in order to offer PrEP an additional preventive option as an additional preventative option.

These people include sex workers, people in a mixed status relationship (a relationship where one of the partners is infected with HIV and others do not) and men who have sex with men.

Global statistics

Human Immunodeficiency Virus (HIV) is one of the most serious public health challenges in the world.

According to UNAIDS, in 2017, there were approximately 36.9 million people living with HIV / AIDS, of which 1.8 million were children.

According to the National AIDS Control Agency (NACA), a Nigerian study of HIV / AID Indicators and Effects (NAIIS) shows that currently about 1,9 million Nigerians live in the disease.

At the global level, approximately 21.7 million people living with HIV (59%) accessed antiretroviral treatment in 2017, 2.3 million since 2016 and 8 million more than in 2010.

AIDS-related deaths have also decreased by more than 51 percent since the beginning of 2004.

In 2017, 940 000 people died from AIDS-related diseases worldwide, compared with 1.4 million in 2010 and 1.9 million in 2004.

PrEP is used globally

South Africa in 2015 became the first African country to approve the use of Truvada as PRepa, followed by Kenya.

According to PrEP's hours (, approximately 16,000 people are currently in South Africa. In Uganda there are approximately 12,000 people in the PrEP, while in Zimbabwe there are about 8,700 people.

It is estimated that 7,800 people currently reside in the PrEP in Tanzania, and in Kenya about 53,000 people are in PrEP.

However, in Nigeria, where some 1.9 million people live with HIV, only about 400 people who are "at high risk of infection" are currently using PrEP.

It puts Nigeria at the bottom of African countries that recommend PrEP in its national HIV guidelines.

PrEP: Not available in hospitals

When PREMIUM TIMES journalist visited some state-owned state-owned hospitals in Abuja, it was felt that drugs could be expensive, as none of the hospitals had PrEP.

The nurse, speaking on condition of anonymity at Kubwa General Hospital, said: "In this country, it's difficult to get PREP. This is very rare and if you get it in private hospitals, it will be expensive.

"In this hospital we have Exposure Prophylaxis (PEP) (used to prevent infection after exposure) and it's free, but we do not have PrEP," she said.

Visiting some private hospitals in Nigeria's capital has also shown that the product is "modest".

None of the private hospitals had PREP when they visited PREMIUM TIMES.

The math in one of the hospitals said: "I advise you to check clinics that are specifically targeted for patients with HIV. You can get them there, but it will cost you," she said.

Reaction of NACA

In an interview with the Director-General of the National AIDS Control Agency (NACA), Sani Aliyu, he said that the federal government can not fund PREP due to costs.

Director General of the National Agency for HIV / AIDS Control, NACA, Sani Aliyu

The drug in the US is about 1,300 USD (N468,000) per month.

"Prophylaxis from exposure refers to people who are being treated with anti-HIV medicines for those who are exposed to HIV several times," Aliyu said.

"Especially men who have sex with men and women who do not use condoms.

"If drugs are on drugs for a long time, although they are exposed to the virus several times, it is unlikely that the virus will be caught.

"Ideally, it should be used together with condoms, because antiviral drugs can only prevent HIV infection, but you will not prevent them from catching other SPIs," he said.

Mr. Aliyu added: "Because of the costs involved, the government can not finance PrEP, but some of our partners finance it," he said. I did not explain it in detail.

PrEP "unrealistic" in Nigeria – an expert

Steve Aborisade, head of advocacy and marketing, non-governmental AIDs HealthCare Foundation (AHF), said the PREP distribution in Nigeria was unrealistic and "may not be possible soon."

He said the drug is too expensive and "will be an additional burden for a country like Nigeria, which is still trying to put people against the antiretroviral drug."

"The main challenge with the PrEP is that it is expensive, in a country like Nigeria and other African countries that are trying to free people living who are living with HIV free of charge, this is an additional burden."

"Nigeria is still trying to overcome the huge gap in the treatment of people living with HIV. Now, it would seem that PrEP is not available.

"The government can not finance PREP procurement in addition to ARVs.

"If we want to be realistic, the means to set them up is not available," he said.


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