Antiretroviral Therapy and Reproductive Behavior in Nigeria: Sex, Marriage and Fertility among People Living with HIV

Benjamin Mbakwem, Community and Youth Development Initiatives (CYDI)
Daniel Smith, Brown University

Nigeria is in the midst of scaling up its antiretroviral therapy program. Current estimates are that 72,000 individuals are enrolled in the expanding program. As people realize that HIV/AIDS is no longer a certain death sentence, they strive to actualize their most important priorities, which include marriage and fertility. Although ART enables people with HIV to hope for and undertake these life projects, it also continues to interfere with them, and achieving these larger goals frequently impinges on people’s capacity to stay on therapy, follow recommended treatment regimes, and take adequate precautions to protect others (and themselves) from further infection. This paper reports on preliminary ethnographic research conducted among people on ART in southeastern Nigeria, focusing on the intersection between antiretroviral treatment, sexual behavior, marriage and reproduction, and the implications for HIV risk. Several emblematic case studies are presented to highlight the key questions and issues that emerge.