By Ojoma Akor
Persons Living with HIV (PLWHIV) in sero-discordant marriages—where one partner is HIV-positive and the other is not—have said that adherence to treatment, proper counselling, among others, have helped them to live healthy and help maintain their partners’ negative status over the years.
They told Health and Science Africa ( HSA) that their experiences showed that HIV was manageable, and not a barrier to love, family or social inclusion.
While an HIV negative partner in a HIV sero-discordant relationship is at risk of becoming HIV infected, some PLWHIV, along with their healthcare providers, have made intensional efforts and adopted strategies that others could learn from.
About 1.9 million people live with HIV in Nigeria, with about 1.6 million on treatment.
A study on sero-discordant couples in the Federal Capital Territory (FCT) of Nigeria some years ago conducted by the Network of People Living with HIV and AIDS in Nigeria (NEPWHAN) showed that females! accounted for 78 per cent and males 22 per cent.
The World Health Organization (WHO) said there were many potential benefits to supporting couples to test together for HIV infection and to mutually disclose their HIV status. This helps them to make informed decisions about HIV prevention and other reproductive health issues.
Stella Ebeh Obianuju (50) said her experience was one of resilience, love and the quiet strength that came from “knowing your truth and living it boldly.”
She discovered her HIV-positive status in 2004 during a routine antenatal visit at the Asokoro General Hospital in Abuja, Nigeria. Shocked by the result, she informed her husband, who agreed to get tested and was confirmed HIV-negative—marking the beginning of their journey as a sero-discordant couple. Despite the emotional and medical challenges, her husband remained supportive.
At that time, treatment options were limited. Stella was given Nevirapine to take during labour and delivered at a different hospital when the time came. Both she and her baby received appropriate postnatal care, and to her relief, the child tested HIV-negative.
She said, “At that time, antiretroviral drugs were not as available as they are today. I was given a single dose of Nevirapine to take when my labour began and was instructed to return to the hospital afterwards. When I went into labour, Asokoro was too far, so I delivered at the Mararaba Medical Centre.
“I informed the nurses there about my status and the preventive treatment. They ensured I took the drug before delivery and referred me back to Asokoro for follow-up care. I was given medications, including Stavudine, for myself and for the baby, and was asked to bring the baby back after a few weeks for testing.
“Thankfully, my baby tested negative at six weeks and again at six months. That gave me hope. My husband stood by me. He said that since we didn’t know my status before marriage and I had already given birth to one healthy child, we would continue together.”
The experience, she said, gave her hope, and that over the years she went on to have six children—all of whom tested negative for the virus, including the one she had before she knew her status.
In 2005, Stella joined a Home-Based Care Volunteer programme where she was trained to support others living with HIV.
Through this experience, she gained a deeper understanding of how to manage a sero-discordant relationship and the importance of treatment adherence.
Her CD4 count remained high, so she was not placed on permanent treatment except during pregnancy. She delivered all her children vaginally, breastfed responsibly as advised and maintained consistent follow-up care.
Stella’s journey was marked by resilience, strict adherence to HIV treatment and strong family support.
She stated that her commitment to medication led to viral suppression, allowing her husband and children to remain HIV-negative. With time, she became a mentor-mother and leader in peer support, guiding others through lived experience.
She stressed the importance of knowing one’s status, open disclosure and proper counselling, especially for discordant couples.
Stella credited organisations like the Institute of Human Virology Nigeria (IHVN) for empowering PLWHIV to become effective role models and champions of prevention and care.
Stella also highlighted the vital role of male involvement and open disclosure in managing HIV in relationships, noting that honesty could save lives.
Asked what she did to help her husband remain negative to the virus, she said, “First, I adhered strictly to my medication—taking it at the correct time, in the correct dose, exactly as prescribed by the doctor. I have never missed a dose; not even once. My viral load has been consistently low. In my last test, it was less than 19, so I am virally suppressed.
“There was a time my husband used condoms, but after I achieved viral suppression, I was advised that he could stop using them. He has since become my treatment partner. He knows my status and supports me fully. For example, I take my medication every morning at 7am, and he is the one who picks up my drugs and gives them to me.
“As my children have grown older, they have also become aware of my status. Now, when it’s time to take my medication, they remind me: ‘Mommy, it’s time. You want to go to work—take your drugs.’ They’ve been helping me, and that support has made a big difference. These efforts—strict adherence to treatment, universal precautions, open disclosure and strong family support—have kept my husband and children HIV-negative. It is possible to be positive and still protect your loved ones. That’s the strategy I used, and it worked for me.”
She further said, “My advice to Nigerians is, first and foremost, every pregnant woman and every woman of childbearing age should go to a hospital to know their HIV status. Knowing your status is the first step.
“Secondly, if you are positive, you need to disclose your status to your partner. But in Nigeria, disclosure is still a challenge. Some people disclose and get support, while others disclose and face stigma.
Another important point is proper counselling at health facilities. Healthcare workers need to provide quality counselling, especially for discordant couples.
“This is a very sensitive area. One thing I appreciate about IHVN is that they use PLWHIV as mentors and role models in the Prevention of Mother-To-Child Transmission (PMTCT).
“Those who wear the shoes know where it hurts—that’s why they are effective role models.Husbands also need to understand the importance of their wives disclosing their status. Disclosure can save the husband’s life, the children’s lives, and even the lives of unborn children.
“Supporting your partner helps to reduce maternal and child mortality and morbidity. The government must do its part to sustain these programmes. Without antiretroviral therapy (ART), some of us wouldn’t be here today. Our children might have been infected—our spouses too. Personally, I might not even be alive today.”
She warned that stigma was more harmful than the virus itself, as it fostered secrecy and increased transmission risks.
She advised: “Families should also understand that stigma kills more than HIV itself. We need to eliminate stigma, because when someone is stigmatised, they may hide their status, avoid treatment and end up infecting others. If my husband had stigmatised me, I wouldn’t have been open with him. I wouldn’t have taken precautions. He could have been infected, and so could our children. Then it becomes a generational problem—what I call generational HIV inheritance—which is not good for any community or the country at large.
“So, discordant couple management should be handled with care. Male involvement in PMTCT must be increased. If I hadn’t involved my husband, I would have been hiding my drugs, and I wouldn’t have been adherent. My viral load would be high, and my children would be at risk. We all have to do the needful.”
Drawing from her own experience, Stella advocated support, communication and government action to end stigma and sustain treatment programmes.
She said, “HIV-positive individuals can have fulfilling marriages with HIV-negative partners, and with proper guidance and support, discordant couples can thrive.”
She recalled helping a Muslim couple overcome religious resistance to their marriage due to the groom’s HIV status.
By sharing her experience and explaining the Undetectable = Untransmittable (U=U) principle, she helped the couple gain acceptance and married safely, with the groom on treatment and the bride on Pre-Exposure Prophylaxis (PrEP).
She, therefore, advocated honesty, support and anti-stigma laws, emphasising that open, informed relationships, especially in sero-discordant couples, could lead to healthy, lasting marriages.
She added that, “As discordant couples, without medication, we could infect our partners. The government should ensure the sustainability of this project. Donors should continue funding IHVN and other implementing partners so they can reach more people.”
She emphasised that such programmes had saved lives, reduced new infections and empowered people like herself to live healthy, productive lives.
Mrs Adeniyi Adetutu Felicia, a 46-year-old baker, discovered her HIV-positive status in 2011 during a hospital visit for a pregnancy test. Devastated and overwhelmed by fear, she believed it was a death sentence.
Upon returning home, she confided in her husband, who agreed to get tested and was found to be HIV-negative. Though the diagnosis brought tension, her husband remained supportive.
Through counselling at the hospital, she learnt that HIV was manageable with proper care. She committed herself fully to treatment, strictly adhering to her medication, avoiding alcohol, smoking, and self-medication, and always consulting pharmacists when needed. Over time, her life normalised to the point where she said she only remembered she was living with HIV when it’s time to refill her medication.
She said, “I was pregnant at the time. Even though he didn’t react negatively, I could see the tension on his face. Honestly, at that point, I thought I was gone. But after receiving counselling and support from the facility, I was advised to stick to my medication and be truthful.
“I learnt that HIV is not a death sentence—you can still live a normal life. I started following the instructions closely: no alcohol, no smoking and no self-medication. If I needed drugs, I was advised to always go through pharmacists so they could provide medication that wouldn’t interfere with my treatment. With all that guidance, life became easier. Now, I don’t even feel like I am living with HIV. The only time I remember is when I need to refill my medication.”
Mrs Adetutu gave birth without complications and now has two children, both of whom tested HIV-negative, along with her husband. She followed all medical protocols, including regular testing during and after breastfeeding. To ensure adherence, she uses an alarm for her medication and receives daily reminders from her children who are fully aware of her status.
Her consistent medical follow-up, openness with her family and unwavering discipline have helped her maintain her health and protect her loved ones. Over 15 years later, she continues to thrive, grateful, healthy, and a living proof that HIV is not a death sentence.
She said, “I have lived this way for over 15 years. In fact, I look healthier than many people who aren’t positive. As long as I adhere to my medication and instructions, there’s no more tension.
“From that time on, I made my medication a priority. I never missed a dose. I took it seriously, and my drugs became my best friend. When I was about to give birth, I used the medication given to me properly and delivered without any issues. To the glory of God, I now have two children, and both are HIV-negative—just like my husband. I followed all the testing protocols: after three months, six months and one year (after stopping breastfeeding), and they all tested negative.
“Since then, I have been committed to attending every hospital appointment and following every piece of advice given. I even use an alarm to make sure I never miss a dose. My children also help—whenever the alarm rings, they say, “Mommy, it’s time to take your drugs,” and they bring the medicine to me. I don’t hide anything from them. They know my status. And by the grace of God, we’ve all been living well.”
Her advice to discordant couples is centered on honesty and openness, and urges partners not to hide their HIV status or medication, as secrecy could damage trust and relationships.
She encouraged individuals to be truthful about their condition, explaining that such honesty brought peace and strengthened the bond between partners.
She said, “I would advise them to be truthful with each other. Be open. Don’t hide anything. If you hide your medication or your status and your partner finds out later, it could destroy the relationship. But when you are honest—saying, ‘This is me, this is what I’m going through’—you’ll find peace.”
She emphasised that many PLWHIV have lived healthy, fulfilled lives for decades simply by knowing their status, adhering to treatment and being transparent with their partners.
She said, “Many of us have testimonies. We have lived like this for 20 or 30 years, still taking our medication, and nothing has happened to us. In fact, we’re even healthier than people who don’t know their status. Knowing your status, getting tested, and adhering to treatment is key. People in relationships should love each other enough to be honest, go for counselling, and learn together. With that, they can live happily and safely as husband and wife.”
She further said love, mutual support, proper counselling, and shared learning were essential for couples to thrive safely and happily together regardless of HIV status.
She called on the Nigerian government to provide economic empowerment opportunities for couples, particularly those affected by HIV, believing that financial support would help families become self-sufficient, enabling them to better care for themselves and their children while maintaining consistent access to treatment and healthcare.
Justine Anungwa discovered his HIV-positive status in 2006 after being hospitalised for vomiting blood and was diagnosed with both TB and HIV.
Though shocked and fearful at first, he began treatment and recovered. His wife tested HIV-negative and has remained so, with their four children. A committed farmer, Justine is grateful that he remains the only one in his family with HIV.
He stressed the effectiveness of antiretroviral therapy (ART), noting that it saved his life and brought his viral load to below 20. He encouraged Nigerians to adhere strictly to their medication, openly disclose their status and seek support. For him, HIV is a manageable condition—easier, in fact, than diabetes—and not a death sentence.
Anungwa urged the Nigerian government to provide economic empowerment for couples, enabling them to support themselves, care for their families and maintain access to necessary HIV treatment.
For Mrs Mabel Ibrahim, a 45-year-old petty trader, she discovered her HIV status in 2005 during a pregnancy, initially believing she only had a fever. The diagnosis left her devastated and overwhelmed with self-stigma, causing her to withdraw from her family out of fear of infecting them.
However, with her husband’s unwavering support and counselling from healthcare providers, she began treatment and gradually regained hope.
Determined to protect her loved ones, she adhered strictly to her medication and kept all medical appointments. As a result, her children, including the one born after her diagnosis, are HIV-negative.
She said,” Walking into a hospital thinking you just have a fever, only to be told you’re HIV-positive, is not something you can just laugh off. That moment came with serious tension when I experienced it firsthand.
“When I told my husband, he didn’t react badly. He encouraged me and told me not to worry. But internally, I was broken. I almost destroyed myself due to self-stigma. I believed I was the only one with the virus.
“I had two children before I got pregnant and found out about my status. That pregnancy was emotionally difficult. My daughter couldn’t come close to me. I felt like the virus was crawling all over my skin. I kept pushing my children away—my husband and even my father-in-law—I started avoiding everyone. I was terrified I would infect them. It wasn’t until the doctor counseled me that I began to feel some peace. The tension is real. It’s only God who can truly help someone through that phase.
“The experience was truly remarkable. God blessed me with a supportive husband. I discovered my status in January, 2005, and immediately disclosed it to him. He supported me from the beginning, and I started taking my medication. To this day, he’s still with me. I vowed to God that I would do everything in my power not to infect my husband or children. I stay adherent to my medication and never miss my appointments.”
Mabel urged the government and donors to continue funding HIV programmes, which she credited for giving her the courage to live again.
Mrs Sheba Henry, a 38-year-old mentor-mother, discovered she was HIV-positive during an antenatal visit—a result that was difficult to accept, especially when her husband tested negative. Despite the shock, she drew strength from his understanding and support. With consistent treatment and care, her viral load is now nearly undetectable, and both her husband and child remain HIV-negative.
Currently pregnant with their second child, Sheba described her journey as one of hope and joy made possible by her husband’s role as her committed treatment partner.
Stella shared that IHVN had been instrumental in her journey for over 20 years, helping to save her life and those of her husband and children.
Through their support, she became Nigeria’s first mentor- mother, joined the Mother-to-Mother support group, and was empowered to lead, mentor others, and deliver both facility and community-based services.
The modest income she earned enabled her to raise three graduates and support her household, reducing dependency and strengthening her marriage.
She also credited IHVN for transforming her from a PLWHIV into a caregiver, role model and empowered champion who now lived free of stigma and with purpose.
