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Understanding HIV prevention and treatment

Jun 9, 2026

HIV Prevention

Understanding HIV prevention and treatment

Nigeria has one of the highest HIV burdens in the world. Despite major advances in prevention and treatment, access to the most effective tools remains uneven, particularly for marginalised communities. This article explains what the key prevention options are, how they work, and where you can access them.

1.8-1.9M
People living with HIV in Nigeria
1.3-1.4%
Adult prevalence (ages 15-49)
99%
Risk reduction with long-acting injectable PrEP

What are PrEP and PEP?

PrEP (Pre-Exposure Prophylaxis) and PEP (Post-Exposure Prophylaxis) are medications that protect against HIV. PrEP is taken before potential exposure to prevent infection, while PEP is an emergency treatment used after a possible exposure has already occurred.

Both may be recommended for people who have had unprotected anal or vaginal sex, shared injectable drug equipment, or experienced another high-risk exposure to HIV. Side effects such as nausea are possible, so speak with a qualified healthcare provider before starting either medication.

Time-sensitive

PEP must be started within 72 hours (3 days) of a possible exposure to be effective. Every hour matters. If you believe you have been exposed, seek medical attention immediately.


How each treatment works over time

PEP (Post-Exposure Prophylaxis)
Emergency treatment taken after a possible HIV exposure. Must begin within 72 hours.
Hour 0
Possible HIV exposure
Unprotected sex, shared needles, or another high-risk event. The clock starts now.
Within 72 hours
Start PEP immediately
Visit a clinic or hospital and begin PEP. After 72 hours, PEP is no longer effective.
Days 1-28
Complete the full 28-day course
Take every dose as directed. Stopping early significantly reduces effectiveness.
Day 28 onwards
Test and assess ongoing prevention
Get tested for HIV. If you are at ongoing risk, speak to your provider about starting PrEP.

PrEP – Daily Pill
Taken daily before potential exposure. Continuous protection when taken correctly.
Day 1
Start daily PrEP
After confirming HIV-negative status with a provider, take one pill each day.
Days 7-21
Protection builds
Full protection for anal sex reached around day 7. For vaginal sex or injection drug use, around 21 days of consistent dosing is needed.
Ongoing
Maintain daily adherence
Missing doses reduces effectiveness. Check in with your provider every 3 months.

CAB-LA (Cabotegravir) Injection
Long-acting injectable PrEP. One injection every two months. Up to 99% risk reduction.
Day 1 + Day 28
Two starter injections
The first two doses are given one month apart to build up drug levels quickly.
Every 2 months
Maintenance injections
A single intramuscular injection every 8 weeks maintains full protection.
Every 3-6 months
Routine HIV testing
Regular HIV testing continues throughout. If you miss an injection window, consult your provider.

Lenacapavir Injection
The longest-acting injectable PrEP. One injection every six months.
Day 1
First injection
A subcutaneous injection administered by a healthcare provider after confirming HIV-negative status.
Up to 6 months
Protection maintained
A single dose provides up to six months of protection, the longest of any available PrEP option.
Every 6 months
Repeat injection and HIV test
Return to your provider every six months for your next dose and routine HIV screening.

ART – Antiretroviral Therapy (for people living with HIV)
Suppresses the virus so people can live full, healthy lives and prevent onward transmission.
At diagnosis
HIV-positive test result
ART is recommended to start as soon as possible after diagnosis, regardless of CD4 count.
Weeks 1-4
Begin ART
Daily oral ART begins. Side effects are common early on but usually subside.
Months 3-6
Viral load begins to suppress
With consistent adherence, most people reach a low viral load within 3-6 months.
6 months onwards
Undetectable viral load
When viral load is suppressed to undetectable levels, the virus cannot be transmitted to others.
U=U: Undetectable = Untransmittable

Long-acting injectable PrEP options

For people who find daily pills difficult to maintain, two long-acting injectable options are approved and available in Nigeria. Both reduce HIV transmission risk by up to 99%.

Every 2 months

Cabotegravir (CAB-LA)
An intramuscular injection administered once every two months by a healthcare provider.
Every 6 months

Lenacapavir
A subcutaneous injection that provides protection for up to six months per dose.

HIV testing and treatment

Regular HIV testing is an important part of maintaining your health, especially if you are sexually active. Knowing your status allows you to access care early and protect yourself and others.

If you test positive, effective treatment is available. ART can suppress the virus to undetectable levels when taken as prescribed. When the viral load is undetectable, the virus cannot be transmitted to others (U=U).

Inclusive healthcare facilities in Lagos and Abuja offer HIV testing, PrEP, PEP, and ART. These include the Centre for Population Health Initiatives (CPHI) in Lagos and the International Center for Advocacy on Right to Health (ICARH) in Abuja.


Lenacapavir access by state

Public health initiatives across several Nigerian states provide access to Lenacapavir injections.

StateFacilities
GombeOne Stop Shop, Gombe Infectious Disease Hospital, Bajoga
Gombe State Specialist Hospital
EbonyiEbonyi One Stop Shop
Alex Ekwueme Federal University Teaching Hospital, Abakaliki
ROMEC Maternity Hospital
AnambraFederal Medical Center, Onitsha
Trauma Center, Oba
Chukwuemeka Odumegwu Ojukwu Teaching Hospital, Awka
KwaraKwara One Stop Shop
Civil Service Hospital
Kwara State University Teaching Hospital
BenuePrimary Health Center Daudu
Federal Medical Center Makurdi
General Hospital North Bank
FCT (Abuja)International Center for Advocacy on Right to Health (ICARH)
Lugbe Primary Healthcare
Maitama Hospital
Cross RiverOne Stop Shop, Bakassi General Hospital, Calabar
General Hospital, Ugep
Akwa IbomOne Stop Shop, Uyo
General Hospital, Iquita Oron
Immanuel General Hospital, Eket

HIV prevention and treatment options are more accessible than ever. Whether through condoms, PrEP, PEP, or ART, protecting your health starts with accurate information and regular testing. Know your status and reach out to a healthcare provider or facility near you. Everyone deserves safe, stigma-free care.