Safe sex has become a luxury for many people in Nasarawa State. Condoms, lubricants and pre-exposure prophylaxis (PrEP) now cost about three times more than before. Health workers fear a new rise in HIV and other sexually transmitted infections (STIs).
Sex Workers Face a Hard Choice
In Lafia, a single condom now goes for N1,000 or more. For sex workers, that price is hard to bear.
Dorcas Patrick, a sex worker, said clients now ask about the cost of a condom before they agree on a fee. Many walk away. “We are not getting customers like before,” she said.
She fears that more people will skip protection. “Not everybody can afford it,” she warned.
Another sex worker, Faith, described the pressure in simple terms. Many women must pick between unprotected sex and going hungry. They know the risks, she said, but hunger also kills.
Dorcas appealed to the government to subsidise condoms and other sexual health items.
How the Funding Gap Began
The crisis traces back to the US decision to pause foreign aid and freeze USAID grants. USAID is the main implementer of PEPFAR. That programme backs roughly 90 per cent of Nigeria’s HIV response, according to the report.
Washington later allowed life-saving treatment to continue. Prevention work, however, did not enjoy the same cover. Outreach, free condoms, PrEP, test kits and STI care all lost support.
Treatment Slips Too
Mrs Ruth Dauda leads the Network of People Living with HIV and AIDS in Nigeria (NEPWHAN) in Nasarawa. She said drug shipments did not stop at once. Other parts of the programme, however, fell apart.
Salaries went unpaid, so many support staff lost their jobs. These workers used to trace patients who missed appointments and bring them back to clinics.
Without them, fewer patients stay in care. As a result, more clients now have unsuppressed viral loads.
Awareness is also falling, she said. Teenagers and young adults know less about HIV than earlier generations did. With little money, groups now focus on pregnant women and people already on treatment.
PrEP and testing remain available at health facilities. Community outreach has stopped, though, and free condoms are scarce.
NEPWHAN’s Monitoring and Evaluation Officer, Philip Lokoko, said the group now struggles to keep up outreach that donors once paid for.
Key Populations Bear the Brunt
Key populations suffer most. The World Health Organization (WHO) uses that term for groups at higher risk of HIV and other infections. They also face social, legal and structural barriers to care.
WHO and UNAIDS list several such groups:
- Men who have sex with men
- Adults who exchange sex for money or goods
- Transgender people
- People who inject non-medical drugs
- People in prisons and other closed settings
Patrick Allu, who coordinates the Key Population Community in the state, said the aid pause shook his members. Meetings, programmes and civil society support have all dropped sharply, he said.
Testing, STI screening and drug pick-ups have become harder. Condoms and lubricants are no longer handed out, so members must buy them. “Sometimes, if we don’t have money, we go ahead and do our activities without protection,” he said.
He urged the Federal Government to raise domestic funding quickly.
Experts Warn of Wider Spread
Health experts say infections climb on every front once prevention fades. That includes gonorrhoea, syphilis and mother-to-child transmission of HIV.
State Government Responds
The Permanent Secretary of the Nasarawa State Ministry of Health, Dr Ibrahim Alhassan, said the state has set up a rapid-response mechanism. It is also starting a State HIV Trust Fund to cover the gap.
He urged residents to practise abstinence and responsible sexual behaviour. He also stressed consistent condom use, regular testing and early treatment.
