A complicated comfort, Nigeria

Anti-retroviral treatment is still only available to a tiny proportion of those who need it in developing countries. Comfort explains how treatment and support from the Network on Ethics, Law, HIV/AIDS Prevention, Support and Care (NELA) changed her life.

Comfort, aged 27, has recently completed a secretarial degree at Ibadan Polytechnic, south-west Nigeria. Last year, she was diagnosed as HIV positive. She has been through a lot of anguish and pain, but her courage is inspiring.

"HIV has caused loss to so many people's lives,” she says. “I see it as a friend – it will always be with me. We eat together, bath together, sleep together. You can’t see it as an enemy as you can't send it away, so take it as your friend."

Comfort thought of herself as a healthy young woman until she began to feel weak, started having recurring malaria and headaches, and lost her appetite. She visited a private traditional medicine clinic and was sent for an HIV test. When the results came back as positive, the clinic did not offer her any counselling, and tried to sell her medicinal herbs that they said would cure HIV, at 40,000N ($300) for a three-month supply.

Comfort thought her life was over. She decided not to tell her friends. "When they know, people don’t want to know you any more," she explains. But she told her older brother, who advised her to go to University College Hospital in Ibadan.

At the hospital, the staff explained to Comfort that it is possible to live with HIV on anti-retroviral treatment. She is one of the 100,000 people eligible for government-subsided drugs, which cost her 1000N ($8) per month – about 10 per cent of the normal cost. So on 29 July 2003, she began her anit-retroviral treatment.

Comfort is now settled into the complicated routine of taking four separate drugs at different times each day. The main problem she finds is making sure she has a nutritious diet. She learned about the importance of nutrition at the hospital, and she feels that if she eats a balanced and nutritious diet at the right time, she can conquer HIV/AIDS. However, even with the anti-retrovirals, she still finds her immune system is weak. In April she contracted typhoid, and when there was a shortage of drugs in January, she became very weak and her CD4 count dropped dramatically. The benefit of her treatment is very clear to her.

Comfort does not plan to tell her parents that she is HIV positive – "It would be very painful for them," she says - but they are starting to wonder why she is still not married. Comfort herself would like to find a husband, but she would like to meet someone who is positive himself, so that he is understanding of her circumstances. She is not finding it easy.

Another major concern to Comfort is access to treatment. As a recent graduate, she has to do a year’s national service in the National Youth Service Corps, and her posting may be up to 13 hours away from her home town, and source of treatment. She is hoping that the hospital will write to ask that she is posted near home.

Like many in Nigeria, Comfort finds money an ongoing problem. While she was a student, her parents gave her money for text books, and she could use this to buy the anti-retroviralss. Now it is harder to find the 1000N ($8) per month, and during her placement she will only receive 7,500N ($56) a month. One of her greatest hopes is to find a good job after the service, to cover her treatment and nutritional needs.

NELA, the Alliance’s linking organisation in Nigeria, gives Comfort ongoing support and advice, as well as drugs to prevent tuberculosis. "NELA have been so good,” she says. “The staff treat me as a family member and a friend. They make me feel appreciated. ‘Prof’ [the Director of NELA] is like a father to me."

Before her diagnosis, Comfort did not know about anti-retroviral treatment. She feels that if more people knew, they would be more prepared to take an HIV test. "Not everyone has the courage to take the test,” she says. “But if you don't know about anti-retroviral treatment, what's the point in knowing if you have HIV?"