Bring HIV back as a family conversation, strategically positioned to curb the menace.
In Anambra State, where HIV's shadow falls heaviest across Nigeria's Southeast, a new stewardship has risen to meet an old and persistent wound. Dr. Nkem Okeke, appointed by Governor Soludo to lead the state's AIDS Control Agency, has assembled a three-year strategy built not on denial but on radical visibility — bringing testing into the night hours, volunteers into every ward, and dignity into the lives of nearly 100,000 people living with the virus. The work is a reminder that epidemics do not end through silence, but through the slow, deliberate courage of communities willing to look at themselves honestly.
- Anambra carries the highest HIV burden in Southeast Nigeria at 2.4% prevalence, a weight made heavier by years of COVID-era neglect that pushed the epidemic out of public consciousness.
- Stigma and discrimination trap 97,423 people living with HIV in cycles of poverty and invisibility, with many unable to find work or access the care that could keep them and others safe.
- The state is deploying 1,693 trained volunteers across all 326 wards and running moonlight testing sessions in high-risk hotspots between 7 p.m. and 1 a.m. to reach those who would never walk into a clinic.
- Anti-discrimination legislation, a new workplace hiring policy, and an empowerment program providing tools and startup funds are being layered together to address the social conditions that fuel transmission.
- Anambra is now one of only eight Nigerian states offering Lenacapavir, a twice-yearly injectable PrEP drug representing the frontier of HIV prevention, with the state's director having taken it himself.
- The entire effort is calibrated toward the global 95-95-95 targets and a declared goal of zero new HIV infections by 2030 — ambitious, measurable, and already in motion.
When Dr. Nkem Okeke took charge of Anambra State's AIDS Control Agency under Governor Chukwuma Soludo, he inherited a difficult truth: the state holds the heaviest HIV burden in Nigeria's Southeast, with a 2.4% prevalence rate ranking fifth nationally. His first act was not to announce solutions but to learn — traveling to Abuja, Lagos, and federal health institutions before returning with a three-year State Strategic Transformation and Sustainability Plan built on eight pillars and aligned with the global 95-95-95 framework. The destination: zero new infections by 2030.
Central to the strategy is restoring HIV to public conversation after COVID-19 effectively buried it. Okeke launched moonlight testing — free HIV screening conducted between 7 p.m. and 1 a.m. in the spaces where vulnerable populations gather — and tested roughly 900 people in his first weeks alone. The state's 176 free testing facilities are now complemented by an HIV Awareness Brigade: 1,693 volunteers drawn from youth groups, women's organizations, faith communities, and primary health care networks, placed across all 326 wards to normalize testing as part of daily life.
But diagnosis is only the beginning. For the 97,423 Anambrans living with HIV, stigma remains a daily barrier to work, dignity, and care. The state has drafted anti-discrimination legislation and a workplace hiring policy requiring employers to evaluate candidates on skill rather than status. The governor's wife, Dr. Nonye Soludo, has woven HIV response into her Healthy Living community health initiative, with 42 local government coordinators ensuring the two efforts move together. Fifty people living with HIV have already received sewing machines, grinding machines, and startup funds — a first step toward a dedicated skill acquisition center the state plans to establish.
Anambra has also been selected as one of only eight Nigerian states to offer Lenacapavir, a long-acting injectable medication taken twice yearly that prevents HIV by blocking viral replication. Okeke has taken it himself and describes manageable side effects. It is reserved for high-risk individuals confirmed HIV-negative, and its availability in the state marks a significant leap in prevention capability. The plan will be formally reviewed in 2028, but the conversation — the one Okeke insists must never go quiet again — has already begun.
Dr. Nkem Okeke arrived at the helm of Anambra State's AIDS Control Agency with a mandate that felt both urgent and daunting. The state carries the heaviest HIV burden in Nigeria's Southeast—a 2.4 percent prevalence rate, the fifth highest in the entire country. When Governor Chukwuma Soludo brought him on board a few months ago, the message was clear: stop the spread. Make it matter. Make people talk about it.
Okeke's first move was not to announce grand plans but to listen. He and his team traveled to Abuja to study what the National Agency for the Control of AIDS was doing, visited the Federal Ministry of Health, consulted the Institute for Virology Management, then went to Lagos to see how that state's AIDS control agency operated. What emerged from those conversations became the State Strategic Transformation and Sustainability Plan—a three-year roadmap anchored on eight pillars, designed to align Anambra with the global target of 95-95-95 (95 percent of people with HIV diagnosed, 95 percent on treatment, 95 percent with undetectable viral loads) and the harder promise: zero new HIV infections by 2030.
The strategy rests on a simple but radical idea: bring HIV back into the conversation. COVID-19 had buried it. People stopped talking about it, stopped thinking about it, began to believe it had gone away. Okeke launched what he calls moonlight testing—free HIV screening conducted between 7 p.m. and 1 a.m. in hotspots where key populations gather. In just the first few weeks after taking office, his teams tested about 900 people. Some tested positive. Some tested negative. The numbers themselves matter less than the fact that people are being tested, that their status is being known, that the invisible becomes visible.
The state now operates 176 free HIV testing facilities. But Okeke knew that clinics alone would not reach everyone. So he created the HIV Awareness Brigade—1,693 volunteers spread across all 326 wards in the state. Each ward has five volunteers drawn from youth groups, women's organizations, traditional institutions, faith-based communities, and primary health care workers. Their job is to move through their neighborhoods, test people, counsel them, talk about HIV as a normal part of life. Training is underway. The governor will formally launch them soon.
Parallel to testing is the work of addressing what comes after diagnosis. Anambra has 97,423 people living with HIV. Many face stigma so severe it keeps them from work, from dignity, from a future. The state has drafted anti-discrimination legislation awaiting the governor's signature. A new workplace policy is in final review—one that will require employers to hire based on skills, not HIV status. The governor's wife, Dr. Nonye Soludo, launched the Healthy Living HIV Control Initiative, pairing HIV response work with her existing community health outreach. Forty-two coordinators across the local governments now ensure that wherever Healthy Living reaches, HIV awareness and testing reach too.
Empowerment has begun. About 50 people living with HIV have already received sewing machines, grinding machines, startup kits, and startup funds through the governor's wife's initiative. The state plans to establish a dedicated skill acquisition center where people living with HIV can learn trades, gain employment, and rebuild economic stability. The logic is straightforward: a person with a job, with dignity, with hope, is less likely to transmit the virus and more likely to stay in care.
Recently, Anambra became one of only eight states in Nigeria selected to roll out Lenacapavir, a long-acting injectable medication that prevents HIV infection. Taken twice yearly, it works by blocking the virus's ability to replicate. Okeke himself has taken it and reports only minor side effects—injection site pain, occasional headache, mild gastrointestinal symptoms. The drug is reserved for people at high risk and those confirmed HIV-negative. It represents the cutting edge of prevention, available now in Anambra.
Okeke is careful about one thing: he pushes back against unconfirmed data circulating on social media about prevalence numbers. As a professional, he says, there are ethics and regulations that govern what can be disclosed. What he will say plainly is this: the burden is real and reasonably high. The fact that Anambra's numbers are so visible is not a failure—it is proof that the state is testing aggressively, that it is looking, that it is acting. By 2028, the plan will be reviewed. By 2030, the goal is zero new infections. The conversation has already begun.
Notable Quotes
HIV is not attached to any name or a personality, so we should not judge people who have HIV.— Dr. Nkem Okeke, Executive Director of Anambra State AIDS Control Agency
It is only when you are tested that your status will be known. And when your status is known, that is when the numbers are affected.— Dr. Nkem Okeke
The Hearth Conversation Another angle on the story
Why does Anambra's HIV prevalence seem so much higher than other states? Is the disease actually worse there?
Not necessarily worse—more visible. When you test aggressively, when you're looking, you find cases. States with low prevalence numbers often aren't testing much. Anambra is being proactive, so the numbers are higher. It's the difference between not looking and looking hard.
So the strategy is to test everyone?
Testing is the foundation, yes. But it's not just about numbers. Once someone knows their status and gets into care, they can be treated. An undetectable viral load means untransmittable—the virus can't spread. That's the real goal.
What about the people who test positive? What happens to them?
They're linked to care immediately. But many face stigma so severe they can't work, can't live normally. So the state is also passing anti-discrimination laws, changing workplace policies, and teaching people skills so they can earn a living and have dignity. A person with hope stays in treatment.
This Lenacapavir drug—is it safe?
It's passed clinical trials and is being used in only eight states globally funded for it. Anambra is one. It's an injectable prevention drug for people at high risk who test negative. Minor side effects—injection site pain, maybe a headache. The director himself has taken it.
What's the real obstacle here? Money? Stigma? Reach?
All three. But the governor is funding it. The stigma is being addressed through law and through changing how people talk about HIV—making it a family conversation instead of a shame. And reach is being solved by putting volunteers in every ward, not just clinics.
By 2030, zero new infections. Is that realistic?
It's ambitious. But it's not impossible if testing, treatment, and prevention all work together. The state is betting on visibility and action rather than silence and hope.