All names have been changed to protect individuals’ identities. Images were AI-generated solely for storytelling purposes.
Amina (30)* is a married woman living with HIV. In a serodiscordant relationship, where she is positive and her partner remains negative, she has faced deep stigma, shame, and episodes of physical abuse. Fear of worsening violence kept her from disclosing her status and seeking support. Isolated from family, friends, and healthcare providers, she endured much of her journey alone.
When Amina began accessing services at a facility supported by the ASPIRE project, she found a team that listened without judgment. With time, trust, and encouragement from professionals, she began to access not only medical treatment but also psychosocial support. Today, Amina is on treatment, taking steps to prioritize her well-being, and finding safe ways to navigate her relationships.
Her story reflects the quiet strength many women bring to their health journeys, even under immense pressure. Across Nigeria, ASPIRE works with individuals like Amina by supporting access to care, challenging stigma, and ensuring no one has to walk the path alone.
Globally, Human Immunodeficiency Virus (HIV) has affected millions, weakening immune systems and progressing, without treatment, to AIDS. In 2003, under the George W. Bush administration, the President’s Emergency Plan for AIDS Relief (PEPFAR) was introduced as an initiative to address this global health epidemic.
Building on this foundation, the ASPIRE project, in partnership with the Institute of Human Virology, was created to tackle HIV/AIDS in Nigeria. Across three implementing states – Abuja, Nasawarra, and Rivers – ASPIRE’s team of healthcare professionals, advocates, and support staff work tirelessly to detect cases early, improve access to treatment, train healthcare workers, and fight stigma head-on, ensuring patients receive not just medication but true care.
A Closer Look at ASPIRE’s Impact: Key Initiatives
In Nigeria, women and children remain among the most vulnerable to HIV, with children especially at risk due to their underdeveloped immune systems. Within the October 2024 to March 2025 reporting period, more than 500 children were reached, with over 9,000 women tested and provided results of their tests. ASPIRE uses targeted initiatives focused on treatment, support, and community empowerment for adequate reach.
Key Initiatives Implemented by ASPIRE:
1. Strengthening Case Findings and Linkages to Care
ASPIRE identifies new HIV cases through a combination of community based testing, facility based testing, and index testing – which involves reaching out to the partners of individuals who test positive. These approaches are particularly effective in identifying sero-discordant couples, families, and members of communities to ensure timely access to care. By delivering services close to home, ASPIRE lowers barriers to testing and improves linkage to treatment.
Once identified, individuals are connected to local hospitals and one-stop care centers, which provide integrated access to testing, treatment, and ongoing monitoring. These centers, in combination with community engagement efforts, make it easier for patients to receive continuous care by meeting them where they are, both geographically and personally.
2. Routine Monitoring to Manage Viral Loads
To ensure that patients maintain viral suppression and reduce the risk of HIV transmission, ASPIRE implements routine viral load testing as part of ongoing care. This testing is typically conducted every 6 to 12 months, following WHO guidelines, to track whether patients’ viral loads remain below 1,000 copies/mL, a critical threshold for preventing transmission.
For patients who face challenges with treatment adherence or show signs of treatment failure, viral load testing may be performed more frequently, such as every 3 months, to enable closer monitoring and timely intervention. This approach helps healthcare providers adjust treatment plans promptly and support patients effectively.
3. Enhanced Adherence Counseling (EAC)
Many patients struggle with medication routines due to fear, stigma, or misunderstanding. ASPIRE’s Enhanced Adherence Counseling (EAC) initiative provides personalized, patient-centered support to help overcome these challenges. Through one-on-one counseling sessions, EAC addresses side effects, clarifies medication schedules, and builds trust between patients and healthcare providers. This holistic approach has significantly improved treatment adherence and health outcomes, fostering greater confidence and empowerment among patients.
4. Building Capacity Among Healthcare Workers
To deliver compassionate and expert care that improves health outcomes, ASPIRE provides targeted training for healthcare workers in both clinical management and empathetic communication. Through focused mentorship sessions, health workers learn how to engage patients effectively, ask the right questions, and manage cases with high viral loads. This comprehensive approach strengthens provider skills and fosters trust, ultimately enhancing the quality of HIV care.
5. Technical Assistance to Strengthen Systems
To maintain uninterrupted and high-quality HIV care, ASPIRE supports facilities by supplying essential medications, collecting lab samples, providing diagnostic equipment, and repairing broken tools. These logistical interventions address critical gaps that could delay diagnosis and treatment, thereby improving service reliability and strengthening patient confidence in the health system.
6. Expanding Access to Free Cervical Cancer Screenings
Recognizing the heightened risk of co-infections among women with HIV, ASPIRE provides free cervical cancer screenings. Between October 2024 and March 2025, over 1,800 women have received free cervical cancer screening. These screenings enable early detection of cervical cancer and uncover other infections, such as hepatitis, facilitating timely and comprehensive care that improves health outcomes.
7. Supporting Serodiscordant Couples
Living safely and with dignity is achievable for sero-discordant couples, where only one partner is HIV-positive. ASPIRE supports these couples by providing pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), helping protect HIV-negative partners and advancing epidemic control within this group.
Progress and Hope for the Future
Through these initiatives, ASPIRE, in collaboration with implementing partners and community networks, has achieved significant success. By supporting 118 private facilities documented between October 2024 and March 2025, viral load suppression rates have steadily improved, empowering more people to live healthier lives, free from fear and stigma.
For patients like Amina, ASPIRE is more than a health program, it’s a partnership rooted in trust, persistence, and community-led care. By working closely with local systems, community organizations, and partners, ASPIRE walks alongside individuals through their journey, helping to ensure that no one is overlooked in the response to HIV/AIDS.
