At The Initiative for Equal Rights (TIERs), we have always known a simple truth about the fight against HIV: the best medical treatments in the world are useless if fear keeps people from walking through the clinic door. Today, we have pills that can suppress the virus to the point where it is untransmittable. Science has done its part. But stigma remains the invisible wall blocking the way, quietly discouraging people from getting tested, picking up refills, or staying on their medication.
This challenge became incredibly real for us and our community recently. When global funding rollbacks hit HIV prevention programming, a wave of anxiety swept through the public health space. There was a very real danger that the virus could re-emerge in places where it had finally been suppressed. We realised that if international resources were shrinking, our local strategies had to become smarter, closer to the ground, and deeply human. We couldn’t just watch from the sidelines.
With the support of ViiV Healthcare’s Positive Action, we launched the Tackling Multi-Layered Stigma project. We didn’t want to make assumptions about why people were avoiding care, so we went straight to the source. We carried out a detailed stakeholder mapping exercise and selected six public hospitals across Lagos, Ogun, and Ekiti states to serve as our pilot facilities.
What we found during this needs assessment was eye-opening. Stigma in a hospital isn’t always loud or aggressive. Often, it’s an uncomfortable look from a security guard at the gate, a hushed whisper at the reception desk, or a lack of privacy in a waiting room. These small, everyday moments are what cause a patient to walk out and never come back.
We knew TIERs couldn’t solve this alone, and we didn’t want to. True impact lies in the power of collaboration. We sat at the table with the National Agency for the Control of AIDS (NACA), the Lagos State Agency for the Control of AIDS (LSACA), and other state partners.
Together with these agencies, hospital staff, and patients, we co-created new Information, Education, and Communication (IEC) materials. We stripped away the cold, scary medical jargon and designed messages in multiple formats using relatable language that speaks directly to everyday people. These materials have now been physically installed across the pilot hospitals, turning cold clinical spaces into visual environments of safety, respect, and dignity.
But posters alone don’t change behaviour; people do. That is why the next phase of our roadmap focuses heavily on intensive sensitivity training for healthcare providers. This isn’t just for doctors and nurses; it is for the administrative staff, the medical records teams, and the security personnel. Every single person a patient interacts with must understand how to provide care rooted in human rights and empathy.
What started as a localised effort to protect our community has grown into something much bigger. In a massive win for sustainability, our co-created materials have now been officially adopted and featured on the NACA national resources dashboard.
This means our six-hospital pilot project is no longer just a temporary intervention; it has become a national blueprint that other states can use to scale up stigma-free care across Nigeria.
We are incredibly proud of this milestone, not because it makes TIERs look good, but because it proves that when civil society and government join hands, we can build a public health system where no one is forced to choose between their dignity and their life. The future of HIV prevention isn’t just about distributing medicine; it is about creating a world where everyone feels safe enough to receive it.
