title: 'No one knows what will happen after these five years': narratives of ART, access and agency in Nigeria.
abstract: Rural Nigerians pursue a range of strategies to maximize current and future access to HIV treatment in the context of securing livelihoods and minimizing the social and economic risks of stigma. This study reports on qualitative interviews with service providers and anti-retroviral therapy (ART) patients accessing care in Benue State, Nigeria, or travelling several hours to Abuja for treatment (n = 34). Nigerians living with HIV are keenly aware of the fragility and complex global and local politics of funding. Their narratives of pervasive stigma, economic and health system barriers to access, growing fears that free ART will cease, and strategies to secure access to care reveal a sophisticated synthesis of social determinants of health and clinical care, and challenge practitioners, planners, and scholars to take a similarly robust and nuanced approach to vulnerability, access, and agency.
authors.affiliation: Institute of Virology, Nigeria (IHVN), Abuja, Nigeria.
authors.forename: Charity
authors.initials: C
authors.lastname: Omenka
authors.forename: Christina
authors.initials: C
authors.lastname: Zarowsky
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000191:economics* / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000188:drug therapy*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006280:Health Workforce; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D011203:Poverty; D011287:Prejudice; D012067:Religion; D057545:Social Stigma; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents