Нигерия запускает пилотную программу по профилактике ВИЧ с помощью препарата PrEP

Health Follow Us on Google August 27, 2026 by Adekunle Yusuf and Dele Anofi Why Nigeria is betting on PrEP to strengthen HIV prevention For years, HIV prevention in Nigeria has largely revolved around familiar messages about condoms, fidelity and testing. But a quieter shift is underway as pre-exposure prophylaxis (PrEP), a preventive medicine taken before potential exposure to HIV, gives people at higher risk another chance to prevent infection before it happens. The National Agency for the Control of AIDS (NACA) is trying to take that message beyond health programmes and into communities, report Associate Editor ADEKUNLE YUSUF and DELE ANOFI For decades, the fight against HIV in Nigeria has been built around familiar messages: know your status, use condoms, remain faithful to one partner and seek treatment early if infected. Those messages remain important. But Nigeria’s HIV prevention strategy is entering a new phase, one in which people at substantial risk of acquiring the virus are being offered another layer of protection before exposure occurs. It is called pre-exposure prophylaxis, or PrEP. The principle is straightforward. PrEP involves the use of antiretroviral medicine by HIV-negative people who are at increased risk of acquiring HIV, helping to prevent infection when taken correctly. It does not replace condoms, HIV testing, fidelity or other prevention measures. Rather, it adds another tool to the prevention arsenal. For the National Agency for the Control of AIDS (NACA), the challenge is not simply making PrEP available. It is ensuring that Nigerians who need it know about it, can access it without stigma and understand how to use it correctly. According to NACA Director-General, Dr Temitope Ilori, Nigeria is still at the early stages of expanding the intervention, particularly with newer forms of PrEP. “PrEP is not for everybody,” Ilori stressed in an interview with The Nation. “We are recommending it for the very high-risk vulnerable groups, maybe by virtue of the work they do, or their sexual habits, risky sexual habits.” Her emphasis is important because the growing visibility of PrEP has also generated questions about whether Nigeria is simply introducing another medical intervention or fundamentally changing the way HIV prevention is understood. For Ilori, it is the latter—but with an important qualification. How PrEP and PEP work PrEP and PEP are two HIV prevention options, but they work at different points in relation to exposure. PrEP, or pre-exposure prophylaxis, is taken before potential exposure to HIV, with the timing depending on the type of PrEP being used. It is designed for people who are HIV-negative but may face a higher risk of acquiring the virus. When taken correctly, PrEP builds protective levels of antiretroviral medicine in the body, making it much harder for HIV to establish an infection after exposure. PrEP is not a vaccine and does not protect against other sexually transmitted infections or unintended pregnancy. Condoms and other prevention measures, therefore, remain important for people that cannot abstain from sex. Available options include daily oral PrEP and longer-acting injectable formulations, including the newer six-month option. However, as NACA DG warned, PrEP is not for everybody, but for people who, because of their circumstances, work or sexual behaviour, may be at higher risk. “We are recommending it for the very high-risk vulnerable groups, maybe by virtue of the work they do, or their sexual habits, risky sexual habits,” she said. PEP, or post-exposure prophylaxis, is different. It is an emergency HIV prevention measure taken after a possible exposure to the virus—for example, following unprotected sex, sexual assault, a condom break or certain occupational exposures. Experts say timing is critical. PEP should be started as soon as possible, preferably immediately, and no later than 72 hours after the possible exposure. It is taken for 28 days, with follow-up HIV testing and medical assessment. The simplest way to remember the difference is: PrEP is protection before exposure; PEP is protection after exposure. According to Ilori, neither intervention should be viewed as a licence for risky behaviour. Rather, they are additional tools in a broader prevention strategy that includes abstinence, fidelity, condoms, HIV testing and sex education. “PrEP is not the only prevention strategy,” she said. “It’s just an available prevention strategy for those that need it.” Read Also: Presidency: Atiku lacks basic understanding of own petrol subsidy proposal From awareness to access One of the biggest hurdles is moving PrEP beyond the circles of HIV programmes, health professionals and people already familiar with HIV prevention. NACA is, therefore, increasingly turning to the media and community organisations to take the message to a wider audience. In recent days, Ilori said, the agency has been engaging media practitioners from across the country, including journalists working in traditional and social media. The strategy reflects a changing information environment. Young adults, in particular, increasingly receive health information through social media, where accurate medical advice competes with myths, half-truths and sensational claims. “We’re trying to educate the media practitioners on the right information so that they can put the right information out there,” Ilori said. But NACA’s approach does not stop at newsrooms. The agency is also working with community-based organisations, civil society groups, non-governmental organisations, people living with HIV and key population groups to spread information about PrEP and where it can be obtained. That community approach matters because HIV prevention does not happen exclusively inside hospitals. It happens in workplaces, schools, communities, relationships and increasingly on digital platforms. The objective, Ilori said, is to ensure that people who need PrEP know that it exists, understand whether they are eligible and know where to obtain it. A new intervention, but not everywhere yet For the optimism surrounding PrEP, availability remains an important limitation. Nigeria is piloting the newer PrEP intervention in eight states, with the selection based on HIV incidence, prevalence and other epidemiological considerations. Akwa Ibom is among the states involved, alongside Anambra, Cross River, Benue, Ebonyi, Gombe and Kwara as well as the Federal Capital Territory (FCT). The intervention is being made available through various levels of the health system in the pilot states, including primary healthcare centres, state hospitals and teaching hospitals. The plan, according to Ilori, is to gradually expand the programme to more states. That means a young Nigerian living in a state outside the pilot areas may not yet have the same access as someone living in one of the participating states. Globally, PrEP uptake remains far below the level needed to significantly reduce new HIV infections, with use particularly low across low- and middle-income countries. A global analysis presented at CROI 2026 in Denver found that funding cuts in 2025 could further threaten progress. Drawing mainly on UNAIDS and country data, the analysis estimated that about 2.3 million people worldwide are taking PrEP, compared with the UNAIDS target of 21.2 million. Investigators stressed that PrEP can have a population-level impact only when it reaches large numbers of people at substantial risk and remains affordable and accessible. Only a handful of countries recorded PrEP-to-need ratios considered high enough to potentially influence HIV incidence: the United Kingdom, Australia, Norway and Denmark among countries with the highest ratios. In most low- and middle-income countries, however, fewer than one person is taking PrEP for every new HIV acquisition. Recent US funding cuts, including reductions in USAID support, have also disrupted PrEP services and reduced coverage in some African countries, particularly among key populations. However, the NACA boss said Nigeria had moved to cushion the impact, assuring that the Federal Government had provided financial and logistical support to sustain HIV prevention services. For eligible Nigerians receiving PrEP through government facilities, cost should not stand in the way of accessing the prevention service. Ilori said PrEP is provided free at government-owned facilities. The same applies to post-exposure prophylaxis (PEP), an emergency HIV prevention treatment taken shortly after a person may have been exposed to the virus. When started promptly and taken as prescribed, PEP can prevent HIV from establishing infection. Providing it free at government facilities helps ensure cost does not prevent timely access. “For now, they are free in government facilities,” she said. The stigma problem Perhaps no HIV intervention can succeed without confronting the stigma surrounding the virus. Despite decades of public education, HIV is still sometimes associated with promiscuity, moral failure or irresponsible behaviour. Such assumptions can discourage people from testing, disclosing their status or seeking treatment. Ilori wants that narrative challenged. HIV, she noted, can be acquired through heterosexual sex, blood transfusion and sharing contaminated sharp objects. Some people are also born with HIV. “It’s not everybody that has contracted HIV that is promiscuous,” she said, arguing for a more compassionate approach to people living with the virus. That compassion is not merely an ethical demand. It is also a public health strategy. When people living with HIV feel safe enough to disclose their status and remain connected to treatment, the benefits extend beyond the individual. Effective antiretroviral treatment suppresses the virus to an undetectable level. When the viral load remains undetectable, the person does not sexually transmit HIV—a principle commonly expressed as Undetectable equals Untransmittable, or U=U. For Ilori, encouraging treatment adherence and reducing stigma are, therefore, part of HIV prevention itself. The message is simple: people living with HIV should be supported to remain on treatment, while everyone should be encouraged to know his or her status. Will PrEP encourage promiscuity? Perhaps the most persistent cultural question surrounding PrEP is whether it could unintentionally encourage more risky sexual behaviour. Ilori’s answer is unequivocal: “I don’t think so.” Her argument is that PrEP is not being promoted as a licence for indiscriminate sex. It is one prevention strategy among several, and eligibility is assessed at health facilities. “We’re not advocating that every, particularly the young, adolescents and young people, we’re not saying everybody should be on it,” she said. At the same time, she argues that policymakers cannot pretend young people are not sexually active. Nigeria has an early mean age of sexual debut, she noted, placing it at about 16 years. That reality creates a difficult policy balance. Ignoring adolescent and young people’s sexual behaviour does not make it disappear. But prevention programmes must also be designed within appropriate ethical, cultural and safeguarding frameworks. For NACA, the answer lies in a combination of proven prevention strategies: abstinence, mutual fidelity, consistent condom use, comprehensive sex education, regular HIV testing and PrEP for people who meet the eligibility criteria. PrEP, therefore, is neither the beginning nor the end of HIV prevention. Rather, as Ilorin puts it, it adds another important layer to the range of options available to people seeking to protect themselves from HIV. 📢 ADVERTISEMENT DISCLAIMER: Links above are sponsored posts. The Nation assumes no liability or responsibility for the claims, products, or services offered by third-party advertisers. Proceed with discretion. Stay informed and ahead of the curve! Follow The Nation Newspaper on WhatsApp for real-time updates, breaking news, and exclusive content. Don't miss a headline — join now! Join The Nation Channel Get instant breaking news and exclusive updates right on your feed! Subscribe to The Nation Newspaper Telegram channel and never miss a headline. Join The Nation on Telegram