Secret health care: A way queer Nigerians get tested for HIV

‘We screen them but do not record them’ — an HIV program in Nigeria’s Plateau state.

llustration by Rex Opara shows a young man wearing a red HIV awareness ribbon. In the background is shattered glass with a bright white light showing in the cracks. (Illustration courtesy of Minority Africa)

By Chinonso Kenneth

Plateau, Nigeria —When 24-year-old Rawlings Easy’s best friend came to the house to run his first HIV test on him, Rawlings didn’t hesitate.

It was October 2021. A final year student at the University of Jos, Rawlings Easy (a pseudonym for his safety) had just learned that his friend had been employed by ICARE Nigeria, a research initiative facilitating HIV treatment procedures for young people. As a social media peer navigator, his friend’s job was to connect young men who have sex with men (YMSM) and young transgender women (YTW) to HIV screening and services.

After explaining the procedure, his friend administered the test.

“He didn’t tell me my result that day. I was so confident that it would come out negative. I didn’t do regular checkups back then because I believed I was careful and [didn’t] sleep around,” Rawlings told Minority Africa.

The next day, his world shattered: he was HIV-positive.

Rawlings felt his life was over. He was worried about how to navigate living with the virus for the rest of his life.

Despite making up less than 1% of Nigeria’s population, men who have sex with men (MSM) account for nearly 20% of new HIV infections, with Nigeria having the fourth largest HIV epidemic globally.. Yet, access to sexual and reproductive health services for LGBTIQ+ persons in Nigeria is scarce, especially for those outside Lagos, Nigeria’s commercial capital and a somewhat more liberal city.

Aside from the Same-Sex Marriage Prohibition law, Francis Aigbokhaevho, an HIV/AIDs and mental health counsellor with the Don Bosco Jesuit Refugee Services, noted how cultural and religious stigma further isolates MSM. These stigmas although prevalent nationwide, are more heavily expressed in places like Jos, While national health policy provides free antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) for Nigerians across all public hospitals, bureaucracy and discrimination often hinder queer men from accessing these lifesaving services.

With the support of his friend and other ICARE Nigeria peer navigators in Jos, Plateau state, Rawlings began his journey toward treatment and acceptance.

“[My friend] took me to a hospital and ICARE paid for my enrollment, hospital card and [other costs]. I’ve been receiving free ART drugs since 2021,” he said.

Social media peer navigators

Funded by the National Institute of Child Health and Human Development (NICHD), the Intensive Combination Approach to Rollback the HIV Epidemic in Nigerian Youth (ICARE Nigeria) program began in 2021, using social media peer navigation and two-way text reminders to boost access to ART for YMSM and YTW living with HIV. Operating in Plateau, Oyo, Lagos, Benue, Taraba, and Kano states, the program has reported increased uptake in HIV testing and medication.

At its Plateau office, located at the old Jos University Teaching Hospital (JUTH), three peer navigators (PN) actively use social media to sensitise YMSM aged 15 to 24 with information about HIV screening and medication.

“We [reach out] through Tinder, Grindr, Facebook, and other queer apps. We tell them about our services at ICARE Nigeria and we schedule screenings either here in JUTH or sometimes at their homes,” says Ethel Ikechukwu, 24, a Mass Communication student at the University of Jos and an ICARE peer navigator.

Darkson Iwodo (pseudonym), 25, was one of the young men who was reached this way. “I was chatting with a queer friend about knowing my status and how I was uncomfortable going to the normal hospital to get tested,” he said. “He told me about the group, that the test could be done at my doorstep, and said he would send my number to one of the peer navigators.”

Darkson’s test came back negative and he was put on PrEP. Since then, he has continued regular screenings with ICARE Nigeria.

For those who test positive, like Rawlings, immediate ART enrollment follows. ICARE Nigeria also runs follow-up screenings and a WhatsApp support group where MSM receive mentorship on safe and healthy sexual practices.

Dakson had his last test in September.

“I started seeing someone lately, whom I’m not sure of his status and we’ve been reckless at some point,” he admitted.

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According to Ethel, since 2021, ICARE Nigeria’s Plateau team has screened over 1,300 YMSM, providing free PrEP and ART. Beyond HIV testing, they also screen for warts, gonorrhoea, hepatitis, syphilis, and staphylococcus infections.

The confidentiality ICARE provides through its private office and home screening services is a major draw for beneficiaries. However, a significant limitation remains: the official age cap. ICARE’s services are restricted to YMSM aged 15 to 24.

“We screen them but do not record them,” Ethel explained. “After the test, we put them on PrEP but not under ICARE record, we just tell the hospital that these are our clients but they are above the age limit so the hospital records it under JUTH, not under ICARE.”

The threat of ‘kito’

One of the biggest challenges ICARE Nigeria peer navigators face in Jos is the threat of getting kitoed – blackmailed and extorted. According to Ethel, peer navigators are sometimes attacked and assaulted when they attempt to provide home screening services.

“Someone told me to come and test him and when I got there he tried collecting my phone, but I was able to fight back, beat him up, and leave,” Ethel said. “They have collected the phones and money of two of my colleagues and so peer navigators are scared to go out and test people because of the risk.”

Francis suggested that incorporating non-queer people as peer navigators might help reduce such attacks, noting that the attackers are taking advantage of the knowledge that the peer navigators are all queer. “They need to bring in other straight people to join in carrying out home screening services; however, they will need to find professionals who can maintain confidentiality on and off the job,” Francis said.

For Rawlings, acceptance of his status has been his biggest achievement. This has allowed him to be consistent with his ART drugs, as that is his lifeline.

In March 2025, Rawlings aged out of ICARE’s eligibility criteria.

This story was first published on Minority Africa and appears here with permission.