Across Nigeria, clinics are reporting disruptions, shortages, and delays in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) testing kits, pre-exposure prophylaxis (PrEP), condoms, community outreach programmes, and antiretroviral therapy (ART) refills.

The interruptions began early this year after the Donald Trump administration halted foreign aid, affecting funds traditionally channelled through the U.S. Agency for International Development (USAID).

USAID has supported several critical health and development programmes in Nigeria, including water resource management under its WASH initiative, nutrition investments, and humanitarian and development interventions in the Northeast. The funding cut has also affected the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which provides essential HIV prevention, care, and treatment services.

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According to the National Agency for the Control of AIDS (NACA), about 1.9 million Nigerians currently live with HIV. As one of the countries with the highest HIV burdens globally, Nigeria has long relied on programmes such as PEPFAR for access to life-saving medications and strengthened healthcare infrastructure.

Over the years, PEPFAR has contributed more than $6 billion to Nigeria’s national HIV/AIDS response. The halt in funding has, therefore, significantly undermined efforts to control the epidemic.

As the global community marks World AIDS Day today, December 1, 2025, under the theme “Overcoming Disruption: Sustaining Nigeria’s HIV Response,” people living with the disease have narrated how they were affected.

Patients speak

In an interview with Daily Trust, a 60-year-old woman, Ada Chukwudi, who has lived with HIV for a decade, said her journey has been one of fear, adjustment, and resilience.

Diagnosed in 2015 at the age of 50, she recalls initially believing the condition was a death sentence until she began treatment and joined a support group that helped her understand HIV as a manageable health issue. She explained that long distances to clinics, long queues, inadequate staffing, and delays in laboratory services remain significant challenges, especially for elderly patients like her.

Despite these difficulties, she said she has managed to live a stable life through strict adherence to medication, family support, and clinic-based counselling. Chukwudi noted that stigma persists in some communities, describing how a neighbour once distanced herself after learning of her status. She called for stronger stigma-reduction campaigns, more community-based drug refill points, better laboratory capacity, and sustained investment in HIV services to ensure treatment remains reliable.

When Musa Rasheedat (not her real name) walked into the antiretroviral therapy (ART) clinic in Lagos last month, she expected her routine refill. Instead, she was met with what she describes as the most frightening statement she has heard since her HIV diagnosis in 2023.

“The pharmacist told me to check back in three weeks, that they were rationing drugs. My heart dropped. How do I go three weeks without ARVs?” Rasheedat said. “This is the first time something like this is happening. I knew then that something was terribly wrong.”

For Yusuf, a university student who has been living with HIV since he was 22, the most immediate impact has been the disappearance of free condoms and lubricants at his clinic.

“I’ve been collecting condoms from the ART clinic to protect my partner from contracting the virus. But I have been told condoms will no longer be free because funding for prevention has stopped,” he said.

Support groups funded by international partners have also stopped operating.

“Our support group for young mothers used to meet twice a month. They gave us transport stipends, nutrition counselling, baby formula. Everything has stopped. Some women stopped coming to the clinic,” said Ada, a mother of two.

For Taiye, who found out his status through routine adolescent testing, the crisis is already affecting early diagnosis.

“I know people who want to test, but the clinic told them testing kits have finished. They just guess they are fine. That is how infections spread,” he said.

Routine viral load tests, funded almost entirely by donors, are becoming erratic.

“My nurse said reagents were delayed because the international partners who used to supply them have paused activities. I felt helpless. How do I know if my treatment is working?” Caroline said.

Yinka is HIV-negative but has been trying to access PrEP for a year.

“They told me PrEP enrolment is suspended, but I learnt it is not officially suspended nationwide. They said they don’t know when new stock will come. How can we end HIV if the prevention drug is unavailable?” he said.

To manage “stock pressure,” some facilities have reduced multi-month dispensing.

“I used to get three months’ supply. Now they give only one. Transport to the clinic costs more than the drugs,” Victoria said.

Ayomide said he is scared of drug resistance because he missed doses.

“In October, they didn’t have one of the drugs in my regimen. The pharmacist said I should manage with what I had at home. I missed four doses. I am scared because doctors always warn us about resistance,” Ayomide said.

Joy, a sex worker living with HIV, said outreach programmes no longer visit brothels and truck parks.

“Before, they came with condoms and testing kits. Now everything has stopped. Many of my colleagues have no idea of their status anymore.”

In Benue State, persons living with HIV/AIDS also expressed concern over how the halt in foreign aid by the Trump administration could affect their treatment. Some of them who spoke to our correspondent in Makurdi said the development threatens years of steady progress in the HIV/AIDS response across the state, which currently counts among Nigeria’s highest HIV prevalence burdens.

Fabian Tor, the State Coordinator of the Network of People Living with HIV/AIDS (NEPWHAN), said the community was thrown into shock when the U.S. announced the suspension of aid.

“Before now, funds from donor agencies supported HIV interventions, but when Trump said he was pulling back, it affected us immediately. Our biggest fear was survival; how would people living with HIV cope?” he said.

Tor noted that while the federal government initially proposed an emergency response plan, it never materialised after the U.S. granted conditional permission for the continuation of basic services such as antiretroviral therapy.

“The plan disappeared, and now we are just hanging. If the U.S. ever decides on a complete withdrawal, what happens to all the interventions built over the years? What happens to the people living with HIV?” he asked.

According to him, gaps in psychosocial support have already emerged, noting that care and support—the heart of HIV management—have been relegated.

“The issue of care and support is completely gone. So, our experience here is that of relegation. We need to talk to somebody. In fact, the whole key to the HIV issue is care, but it now looks like care cannot be given anymore, support cannot be given anymore. We deal with trauma, suicidal thoughts, denial, and stigma. Without psychosocial services, these issues worsen. Treatment alone is not enough,” he added.

Similarly, Evelyn Terver, Coordinator of the Association of Positive Youths Living with HIV/AIDS in Nigeria (APYIN), Benue State chapter, described the panic that followed the announcement.

“When news of the withdrawal broke, many people were worried about how they would buy their medications. In some families, both mother and child are on treatment. In others, every member is HIV positive. Buying drugs will be impossible for many. It will be a major challenge,” she said.

Zonal Coordinator of NEPWHAN, Ali Baba, raised concerns over disruptions in staffing and community services as implementing partners exit.

“Implementing partners are pulling out, and their staff are being merged into the state workforce. But now, certificate issues are coming up, and some people who have worked for years may lose their jobs because they don’t have formal degrees. Experience is being ignored,” he explained.

He also said the state’s budget-release delays could affect HIV programming.

“As we speak, we are identifying new cases without test kits. Prevention without testing is impossible. This will trigger a surge in new infections,” he warned.

He added that stigma remains high at the community level and that integrating partner-trained health workers with state workers may create behavioural challenges.

“The stigma is still with the community, and we need to put away the stigma not to scare people away from receiving the treatment. Now, the way nurses assist the people is different from those trained by implementing partners. Their behaviour is quite different and cannot be the same. So, now that we are integrating, it will be a behavioural challenge,” Baba posited.

In Bauchi, the Coordinator of NEPWHAN, Abdullahi Ibrahim, warned that though treatment is still being accessed, the level of support has significantly declined.

“The Executive Order signed by Trump has not fully taken effect yet because we are still accessing treatment. But the difference is clear—services previously supported by the USAID have reduced,” he said.

According to Ibrahim, essential services that patients relied on have weakened, sparking fears that further cuts could lead to devastating consequences across the country.

“Some of the services we used to get have been reduced. If they stop completely, it will be a big problem for people living with HIV, not just in Bauchi but nationwide. For now, we are still getting the life-saving treatment, but the support services are no longer what they used to be,” he added.

He warned that reduced funding poses multiple risks, including a resurgence in new infections and treatment interruption for existing patients. He urged the federal government to urgently step in and ensure uninterrupted drug supply.

“Our major plea is drug availability. Even if foreign support stops, the government must intervene. COVID-19 was tackled decisively—HIV should be treated with the same urgency. Mobilise people to know their status, make drugs available, and sustain support from other donors,” he said.

A patient, Saadatu Ibrahim, described the announcement of halted funding as a “death notification” for many living with HIV, especially the poor.

“With the economic hardship and the cost of buying drugs, this information is frightening. If funding stops, it means we must start preparing to buy the drugs—or prepare for death. The government must act to prevent the spread of HIV from escalating,” she said.

She appealed to the government at all levels, as well as corporate bodies, to intervene before the situation worsens.

95% of Nigerians on HIV treatment can no longer transmit virus – NACA

Meanwhile, the Director General of NACA, Dr. Temitope Ilori, says 87 per cent of people living with HIV in Nigeria know their status, 98 per cent of those who know their status are on life-saving treatment, and 95 per cent of those on treatment have achieved viral suppression and can no longer transmit the virus.

Speaking during a press briefing in Abuja, Ilori observed that Nigeria remained firmly on track to end AIDS as a public health threat by 2030, adding that the country had continued to record important milestones in its HIV response.

She stated, “Nigeria remains firmly on track to end AIDS as a public health threat by 2030. We will not stop until that goal is achieved. Over the past year, Nigeria has continued to record important achievements in its HIV response. We have maintained an impressive 87–98–95 performance toward the global 95–95–95 targets, demonstrating significant progress in diagnosis, treatment coverage, and viral suppression across the country.

“Eighty-seven per cent of people living with HIV in Nigeria know their status, 98 per cent of those who know their status are on life-saving treatment, and 95 per cent of those on treatment have achieved viral suppression—meaning they cannot transmit HIV.

“In the last decade, Nigeria has recorded a 46 per cent decline in new HIV infections, and more Nigerians living with HIV are enrolled and retained in care than ever before. State-led efforts in the prevention of mother-to-child transmission have strengthened early infant diagnosis and pediatric treatment, though these areas continue to require focused attention.”

Experts speak

Meanwhile, experts have warned that the resulting vacuum is reshaping the HIV response in Nigeria—and not for the better.

In an interview with Daily Trust, Dr. Udoh David, an infectious disease physician, said the past ten months have been the toughest in his 10-year career.

“The funding cut hit like a bomb. Prevention programmes were the first casualties—condoms, PrEP, community testing kits, adolescent outreach. These things seem small, but they are the backbone of prevention,” he said. “For years, we have relied on PEPFAR and the Global Fund. Nigeria has not invested anywhere near enough to replace what we’ve lost. The gap is staring at us.”

Dr. Godwin Ekuwke, a medical practitioner at the Kubwa General Hospital, Abuja, said Nigeria must prioritise prevention strategies to reduce new HIV infections, noting that early testing and treatment remain central to controlling the epidemic. He emphasised the importance of public awareness and consistent engagement with young people, key populations, and high-risk communities.

“Prevention remains our strongest tool against HIV. We need more people to embrace regular testing, safer sexual practices, and early treatment when diagnosed. Once you start treatment, the virus becomes undetectable and untransmittable—that is a scientific fact,” Ekuwke said.

He added that strengthening community-based testing, expanding access to PrEP, and debunking myths are crucial steps in ending HIV transmission.

FG strengthens HIV response

The federal government says it is intensifying efforts to strengthen Nigeria’s HIV response through increased domestic funding, improved programme coordination, and sustained collaboration with global partners.

In an interview with Daily Trust, Dr. Adebobola Bashorun, the National Coordinator of the National AIDS and STIs Control Programme (NASCP) at the Ministry of Health and Social Welfare, said the ministry has continued to expand the national HIV treatment and prevention programme, led by NASCP, to ensure every individual living with the virus is identified and placed on treatment.

“The Ministry of Health is doing a great deal to strengthen its response and overall performance in controlling the HIV epidemic. NASCP remains the engine room of the health-sector HIV response, both in treatment and prevention,” he said.

He explained that Nigeria’s HIV treatment programme began in 2002, though the national response dates back to 1987. According to him, once effective HIV treatment became globally available in the mid-1990s, the federal government moved quickly to adopt it.

“Under the leadership of the President in 2002, the national HIV treatment programme officially commenced under NASCP,” he said.

Dr. Bashorun noted that the government has consistently invested in procuring antiretroviral medicines, while international partners such as the U.S. government and the Global Fund have offered crucial support. He, however, claimed that U.S. assistance to Nigeria has not been withdrawn.

“What the U.S. government has done is reprioritise its funding. Rather than stopping support, they are focusing it more strategically to improve efficiency and impact. This is well within their right as a sovereign nation,” he said.

He added that the federal government has increased its own funding to ensure long-term sustainability.

“Earlier this year, the President approved nearly $200 million as emergency response funding. This means we have a strong backup and a sustainability plan,” he said.

Asked his message to Nigerians on this year’s World AIDS Day, Dr. Bashorun emphasised collective responsibility and individual health awareness.

“As a nation, we must support our government’s efforts to control the HIV epidemic. As individuals, everyone should know their HIV status. If you are negative, stay negative. If you are positive, do not panic—start treatment immediately,” he said.