How Do You Want to Live? 

T-dok … T-dok … T-dok …. The ping pong ball volleys back and forth across the table tennis table net.

A group of boys lie on the cement floor, crowded around a spirited game of mancala. Smiling girls skip rope. A soccer ball skitters back and forth among preteens amid laughter and competitive shouts. 

A recreation center? No. These kids are playing on the veranda along the back of First Referral Hospital Mutum Biyu in Taraba State, Nigeria, doing what kids do everywhere in the world … simply playing.  

We visited this hospital in 2024 to meet some of the children and adolescents living with HIV who are receiving care at this hospital and to visit the Adolescent and Youth Friendly Center. A child living with HIV who is on treatment is as healthy as any other child and should do what any other child does, have the same dreams as any other child. Yet, enduring stigma around HIV often leaves children born into this circumstance feeling hopeless and outcast. The Adolescent and Youth Friendly Center is designed to ensure children’s access to treatment, educate them about their condition, and give them a space to just be kids. 

This is particularly important in Nigeria, where there is a significant treatment gap when it comes to children. Less than half of the 82,000 children living with HIV are on lifesaving treatment.

Each year, around 15,000 Nigerian children die from HIV-related illnesses. These deaths are completely avoidable. Service locations like this are designed to help children survive and thrive. 

Comfort Samuel, a peer supporter, explained some of the emotional challenges that a child living with HIV might face: “If I was stigmatizing myself, I might have ended up poisoning myself, killing myself, or harming myself one way or the other.” 

I spoke to Comfort at the hospital in Mutum Biyu while other mentors and health workers engaged children in activities. At that time, she was a 22-year-old university student studying political science and international relations (since graduated). She’s been volunteering as a peer supporter since she was 16. As someone who grew up with HIV, Comfort understands the challenges that children face and can be a big sister of sorts. She said that it is important to experience the “mindset of the children” when she talks to them about why they need to adhere to their medication.  

“When I have a one-on-one [conversation] with the children, they open up; they feel free and relate to some of the issues they have. They become so comfortable, and I know most of their problems.” It is important for children to understand their own stories and to accept themselves. 

Overcoming Stigma: Comfort’s Story 

Comfort has been living with HIV since she was an infant. She remembers being given tablets to take every day as a child but not knowing that those were antiretroviral (ARV) medications. Her mother died from AIDS-related illness when she was 9. Her father tried to shield Comfort from the fact that she also had HIV, so he did not tell her about her status.  

But she knew that she was somehow different from other children. Her stepmother separated Comfort from the others: 

“She discriminated against me and stigmatized me,” said Comfort. “I even had my spoon differently. My cups were different. My plates were different. My [laundry] basket was completely different. In fact, I don’t even stay in the main flat, so she isolated herself from me.”  

And Comfort wondered why she was taking medication when others in the household were not. There was no adolescent and youth-friendly service center at that time to help her understand. 

“I asked my dad why I was taking drugs, and he said that I should not worry.” At the age of 12, Comfort’s medication changed to an adult formulation. Again, she asked why she was taking the daily drugs. “He still says when I grow up, I will understand.” 

“And one day [at the age of 15], I just decided not to take my medications again … because I don’t know what it was meant for. I’ll drop it under my bed or throw it away,” recounts Comfort. 

The result was that she broke out in rashes and became sick. When she went to the health center, the doctor, following a discussion with her father, finally disclosed that she was living with HIV and that her viral load was high due to her break in ARV adherence.  

“So that was when I knew my [HIV-] status,” said Comfort, “It was kind of strange and surprising, I couldn’t believe it.” But she got back on treatment and kept taking her medication until her viral load was low.  

Ironically, out of care for his daughter, Comfort’s dad had inadvertently put her at risk. “Because he was scared that I might not accept the fact that I was positive,” says Comfort. “He was scared of losing me just the way he lost my mom. So, he decided to keep it as a secret.”  

Comfort said that had she known that she had the same condition as her mother, she might have acted differently: “If I had known that this was the case, I would have continued to take my medication to stay alive and stay healthy.” 

As an adult, Comfort still faces stigma. She has been fired from jobs because she is living with HIV. This is why she wants to instill confidence and resilience in the children at the center—so they will take their medication and live, and so they will know who they really are, even if others do not.  

“Discrimination and stigma [are] nothing to me,” Comfort said. “I overcame the social stigma from the family. I was able to cope with it because deep down inside of me, I know what it takes to be positive, and I know where I’m going to.” 

Boosting Immunity, Boosting Self-Esteem 

“When a child is diagnosed with HIV, [it helps if] he knows that he’s not alone,” said Comfort. “When you feel you’re the only person, you feel stigmatized, and you feel lonely.  

“When you come to a program like this support group, you see other children with similar cases like yours, [and] you feel like, ‘Oh, I’m not the only person.’ You begin to make new friends, and you become lively. We discuss some of your issues with them. Maybe you’re not taking your medications, and you meet a friend who is taking [the ARVs]. Then that child will start taking his as well.” 

Comfort said that with the children she works with, she wants to see self-stigma go down as they get healthier: “So, they have a lower viral load that boosts their immunity but also boosts their self-esteem.  

“What gives me excitement is when I see a child say, ‘I am HIV-positive, and I’m taking my medications.’ I love that aspect … because we [socialize] children to accept themselves, to love themselves. When they begin to love themselves, then they can say, ‘I have a future.’”  

She tells the children that they can get married, and that they can have HIV-free children. “With that, they will be so excited that, ‘Oh, there’s life beyond HIV.’”  

“You’re going to live as old as God wants you to live on earth,” Comfort tells the children. “In fact, you can be healthier than anybody. So how do you want to live?”  

“You’re going to live as old as God wants you to live on earth. In fact, you can be healthier than anybody. So how do you want to live?”  

Comfort samuel, peer supporter