1. Background
Adolescents and young people living with HIV (YPLHIV) face unique and intersecting challenges in accessing sexual and reproductive health and rights (SRHR) information, services, and legal protection. While advances in HIV treatment have improved life expectancy and quality of life, many young people continue to experience stigma, discrimination, confidentiality breaches, and social exclusion because of their HIV status. These challenges often limit their ability to make informed decisions about their sexual and reproductive health, access appropriate services, disclose their status safely, and exercise their rights without fear of judgment or abuse. In Nigeria, and particularly in Oyo State, evidence on the SRHR experiences and legal protection needs of YPLHIV remains limited, despite growing recognition of the importance of youth-centered and rights-based HIV responses.
To better understand these challenges, PLAN Health Advocacy and Development Foundation (PLAN Foundation), in collaboration with the Association of Positive Youths in Nigeria (APYIN) and DorcasGrace Community Initiative, conducted a rapid assessment among adolescents and young people living with HIV in Oyo State and neighbouring locations. DorcasGrace Community Initiative is community-based organization working to promote sexual and reproductive health and rights, gender equality, women’s empowerment, and prevention of gender-based violence. The assessment explored participants’ experiences relating to SRHR knowledge, access to HIV and SRHR services, stigma and discrimination, psychosocial wellbeing, rights violations, and access to legal support. Findings from the assessment provide valuable insights into the barriers affecting the health, dignity, and wellbeing of YPLHIV and highlight opportunities for strengthening legal empowerment, strategic litigation, youth-friendly services, psychosocial support, and community-based advocacy to advance their sexual and reproductive health and rights.
2. Profile of Respondents
- A total of 15 participants (ages 17–30 years) from Oyo and neighboring states participated.
- Age range: 17–30 years
- Majority living in Ibadan; others in Lagos, Osun, Ilorin.
- Length of diagnosis: 11–21 years, including several born with HIV.
3. Emotional Experience When Learning HIV Status
Many participants described:
- Fear, shock, deep worry about stigma.
- Self-stigmatization, crying, emotional distress.
- A few received support from:
- Mothers,
- Health facility counselors,
- Support group leaders.
Several participants experienced parental loss, compounding emotional impact.
4. Knowledge of SRHR Rights
Understanding of SRHR varied widely:
- Some clearly articulated rights to make informed decisions, access services, and avoid discrimination.
- Others had little or no understanding of their SRHR.
- Some expressed guilt or fear related to sexuality because of HIV status.
5. Access to SRH/HIV Services
5.1 Experiences Accessing Services
- Only one respondent reported positive, discrimination-free access.
- Majority could not access services such as family planning, antenatal care, or STI testing.
- Some were denied certain methods, e.g., told condom was the “only option”.
5.2 Key Barriers Identified
- Discrimination by healthcare workers
- Facility attitude (judgmental, unfriendly)
- Service unavailability
- Financial constraints & transport issues
- Lack of youth-friendly services
- Fear of stigma
6. Youth-Friendliness of Facilities
- Mixed experience:
- Some youth-friendly facilities exist.
- Many participants described facilities as unwelcoming, judgmental, or inconsistent in their attitude.
7. Sexual Relationships & Reproductive Intentions
7.1 Impact on Relationships
- Several faced partner rejection after disclosure.
- Some hide their status from partners.
- Others feel unaffected due to secrecy or acceptance.
7.2 Motherhood Intentions
- Most desire future motherhood.
- Expressed need for:
- Supportive partners
- Respectful, nonjudgmental healthcare
- Accurate counselling
- Reduced stigma
One participant expressed desire for an HIV cure before feeling fully safe.
8. Stigma, Discrimination & Rights Violations
Most respondents:
- Did not report overt discrimination, but:
- Several cited breaches of confidentiality (e.g., nurses disclosing private information).
- Some were denied certain SRH services.
- Many expressed fear of stigma even when not directly experienced.
A few reported cases where:
- Rights were violated but not pursued legally.
- School management intervened in a rights violation case.
9. Psychosocial Well-Being
Key issues:
- Loneliness, especially among those without strong support systems.
- Feelings of worthlessness, hopelessness, and social withdrawal.
- Improved wellbeing where counseling or family support existed.
- Peer groups and counselors were described as highly helpful when available.
10. Awareness & Access to Legal Support
Most participants:
- Have not accessed legal help.
- Barriers include:
- Cost, fear, lack of awareness, and poor accessibility.
- Majority indicated they need:
- Rights education
- Free legal representation
- Support in reporting abuses
Many are willing to participate in strategic litigation, if supported.
11. Key Challenges Identified in Oyo State
- Lack of youth-friendly spaces
- Financial constraints
- Poor provider attitude
- Fear of judgment and stigma
- Low awareness of SRHR & rights among young people
- Limited access to services for single women and adolescents
- Inconsistent availability of SRHR information
12. Suggested Improvements from Respondents
Young people recommended:
- Youth-friendly clinics and respectful HCWs
- Privacy and confidentiality protections
- More awareness and education on SRHR
- Free or subsidized SRHR services
- Digital and online counselling
- Greater availability of SRHR services at HIV clinics
- Supportive environments for disclosure
13. Willingness for Peer Support & Advocacy
Most respondents are willing to be involved in:
- Advocacy,
- Peer education, and
- Community engagement.
They need:
- Training, mentorship, and emotional support
- Transportation and data support
- Platforms to speak
- Psychosocial strengthening
14. Summary of Core Gaps Identified
Service-Level Gaps
- Non-youth-friendly facilities
- Provider discrimination
- Low availability of SRHR services
- Cost and transport barriers
Rights & Justice Gaps
- Confidentiality breaches
- Lack of legal knowledge
- No formal channels to report rights violations
- Barriers to accessing legal help
Psychosocial Gaps
- Loneliness and self-stigma
- Limited peer-support structures
15. Implications for Strategic Litigation Focus
Findings indicate a strong need for:
- Legal literacy for YPLHIV
- Documentation and reporting of rights violations
- Free and accessible legal representation
- Supportive systems that protect privacy and dignity
- Litigation and advocacy addressing:
- discriminatory SRH service denial
- confidentiality breaches
- youth unfriendly practices
gender-based and HIV-related stigma
16. Conclusion
The findings of this rapid assessment demonstrate that adolescent and young people living with HIV (YPLHIV) in Oyo State continue to face significant barriers to realizing their sexual and reproductive health and rights. These barriers include stigma and discrimination, breaches of confidentiality, inadequate access to youth-friendly SRHR services, limited knowledge of SRHR and legal rights, financial constraints, and psychosocial challenges such as loneliness, self-stigma, and social isolation. The assessment further highlights gaps in legal empowerment and access to justice, with many participants unaware of available legal remedies or unable to access support when their rights are violated. These challenges undermine the health, dignity, wellbeing, and full participation of YPLHIV in society.
Despite these challenges, the assessment revealed strong resilience and willingness among YPLHIV to participate in advocacy, peer education, community engagement, and strategic litigation efforts when provided with adequate support. Addressing the identified gaps will require coordinated interventions that combine rights education, legal literacy, strategic litigation support, youth-friendly and disability-inclusive health services, psychosocial support, and strengthened accountability among healthcare providers and public institutions. The findings provide a strong evidence base for targeted investments and partnerships aimed at protecting the rights of YPLHIV, improving access to quality SRHR services, and creating an enabling environment where young people living with HIV can live healthy, productive, and dignified lives.
PLAN Foundation is a member of the International Association of Providers of AIDS Care (IAPAC), the World Patients Alliance (WPA), the International AIDS Society (IAS), the Global Network of People Living with HIV (GNP+), the Stop TB Partnership, the International Alliance of Patients’ Organizations (IAPO), the International Union Against Tuberculosis and Lung Diseases (IUATLD), the Global Health Council (GHC), as well as various other relevant regional and global networks, movements, and professional associations aligned with its vision of a Nigeria where the individual, family, and community are adequately empowered to protect themselves against poverty, underdevelopment, and the spread of diseases.
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Felicia Abosede Ojo,
Gender and Social Inclusion Officer,
PLAN Health Advocacy and Development Foundation (PLAN Foundation),
Ibadan, Nigeria
+234 803 352 7668
abosede@planfoundation.org.ng
