Testing
An HIV test is a finger-prick or a blood draw and takes minutes. In Nigeria, government hospitals, primary health centres and many NGO clinics test free of charge and confidentially; you do not have to explain how you might have been exposed. Self-test kits are sold in pharmacies in larger cities. In the United Kingdom, any sexual health clinic tests free, you do not need a GP, and nobody asks about immigration status. Free postal self-test kits are available in England through the NHS.
If the result is positive
- It is not a death sentence. With treatment, life expectancy is normal. I mean that literally.
- Start treatment as soon as you can. In Nigeria, antiretroviral drugs are free through government treatment centres, supported by the national programme. In the UK, treatment is free on the NHS for everyone, regardless of immigration status; sexual health services do not report to the Home Office.
- Take it every day. Usually one tablet, same time each day. Within months most people are undetectable.
- Tell one person. Not the church. One person.
- Call the support line. I have had this conversation with strangers many times. It helps.
U=U
Undetectable equals Untransmittable. A person on effective treatment whose viral load is undetectable cannot pass HIV to a sexual partner. This has been confirmed by large studies and is the position of the World Health Organization, UNAIDS, the British HIV Association and Nigeria's own national agency. If someone tells you otherwise, they are wrong, whether they are a pastor or a nurse.
PrEP
Pre-exposure prophylaxis is a daily or event-based tablet that prevents HIV in people who are negative. In the UK it is free from sexual health clinics. In Nigeria it is available through some public and NGO clinics, particularly those serving key populations; ask the support line for the nearest we know of.
In Nigeria, specifically
The National Agency for the Control of AIDS coordinates free treatment through hundreds of sites. Stigma is the main reason people do not go. Some things that help: choose a treatment centre away from your neighbourhood, collect several months of medication at once where it is allowed, and remember that a clinic's staff have seen every kind of person and legally cannot disclose your status. If a health worker treats you badly for being gay, you can leave and go to another; you do not owe anyone your story.
In the United Kingdom, specifically
Find your nearest sexual health clinic online; you can walk in or book. Treatment is free from the first day, including for asylum seekers, overstayers and visitors. Terrence Higgins Trust runs a helpline, 0808 802 1221, and has support for African communities. Positively UK, NAZ and the African Advocacy Foundation work specifically with Black African people living with HIV.