Access to anti-retroviral drug (ARV) therapy in Nigeria has been a big challenge. Despite the
fact that ARVs have been demonstrated to improve quality of life, reduce AIDS prevalence
and AIDS deaths, many people in Nigeria still do not have access to ARV therapy. At the
time this study was started, the ARV access rate was 16.6%. This Grounded Theory study
examines the experiences of HIV positive people accessing ARVs in Abuja, Nigeria. 30
Patients living with HIV/AIDS were interviewed in an iterative manner. The results of the
Grounded Theory analysis were triangulated with the documentary analysis of preliminary
and secondary literature. As reported by the participants of the study, patients initially found
it very difficult to access treatment. Stigma emerged as the main concern of the research
participants. Although access to anti retroviral treatment has improved over the years,
different forms of stigma still pose important barriers to access in this group of participants.
The results of this research suggest that stigma occurs at individual, familial, community,
organisational and national levels. The main concern of research participants was resolved
mainly through the use of social connections. The contribution to knowledge is the
development of the Social Connection Theory. 5 main stages that patients pass through
when they attempt to access ARVs were identified in this study. During each of these
stages, the patient may experience barriers through stigma or other forms of structural
issues such as poverty. They may also move from one stage to another through social
connectors who assist them to access ARVs. In the Social Connection Theory, it is argued
that in African settings, social connectors play a vital role in influencing the way that patients
access antiretroviral treatment. Social connectors are social acquaintances of the patient
who help shape their health care seeking decisions. They play a vital role in supporting and
linking HIV positive persons to where they can access ARVS. Social connection serves as a
useful tool for empowering HIV patients to overcome different obstacles and access
treatment. However, these processes do not occur in a structural vacuum. Structural factors
such as religion, gender, politics and the economy were also found to shape the way stigma
is experienced in Nigeria and how people access HIV treatment. To improve access to
ARVs, it is suggested that while taking cognisance of structural forces, multidisciplinary
strategies should be developed that integrate social connectors at different critical points in
the access continuum