Some children do not inherit wealth, or safety, or even certainty. They inherit a virus, a silence, and a lifetime of questions they never asked.
Usman (not his real name) loved Mariam. For years, they planned a future together, but when it was time for marriage, his family refused. Culture was their reason, tradition their shield. After a long struggle, he gave in and married the woman they chose for him, but he did not let go of Mariam. He continued seeing her privately, holding on to what he believed was love.
Then his wife gave to their first child. But when the child he fell ill and tests were run, the diagnosis came back heavy and unforgiving. HIV.
The shock was only beginning. His wife was HIV positive. He was HIV positive. And somewhere in the painful unravelling of truth, it emerged that his wife and her family had known. He did not know. She had been on treatment, but failed or was ignorant about taking the necessary medication to prevent mother to child transmission. And so, the child was born into a lifelong battle.
In the middle of his pain and confusion, Usman had to confront another truth. Mariam. She too tested positive. There are some of those stories that break quietly but linger for a lifetime.
Mary’s story is different. She was a devoted wife, healthy, hopeful, stepping into marriage with trust. When her baby girl was born sickly, confusion quickly turned to fear. Then came the diagnosis. The child was HIV positive. She was HIV positive. Then her husband disappeared. He left them in the hospital and never returned.
It was a relative, burdened with both pity and truth, who revealed what Mary had not been told. Her husband had been living with HIV long before the marriage. Chima had known. And yet, nothing was done to protect her. Nothing was done to protect the child. The one life that should have been shielded above all else entered the world already fighting.
There is something deeply troubling about a child carrying a burden they had no part in creating.
In many public health facilities across Abuja, mornings at HIV clinics tell their own story. Children in school uniforms sit quietly, waiting. Toddlers cling to their mothers. Teenagers look away, already learning to carry stigma before they fully understand it. On some clinic days, a large number of patients are children. Babies, preteens, adolescents. Lives just beginning, already marked by something that could have been prevented.
Nigeria continues to carry one of the heaviest HIV burdens in the world. According to UNAIDS, about two million people are living with HIV, with roughly 160,000 of them being children between ages zero and fourteen. New infections continue. Thousands of children remain undiagnosed. And behind these numbers are stories that are rarely told in full.
The deeper concern, health experts say, is not just the numbers, but the gaps. Gaps in awareness. Gaps in testing. Gaps in prevention.
At a recent paediatric HIV meeting in Abuja in April 2026, stakeholders spoke of the children who are still being missed. Infants not diagnosed early enough. Mothers who are not adequately informed. Opportunities to prevent transmission lost in moments that should have been decisive.
With the right care, guidance, and treatment, mother-to-child transmission of HIV is largely preventable. But prevention depends on knowledge. It depends on testing. It depends on honesty within relationships. It depends on removing the silence and stigma that cause people to hide, delay, or ignore what should be addressed early.
Children depend entirely on adults. They do not choose. They do not negotiate. They receive. And when systems fail, when awareness is low, when responsibility is avoided, it is the child who carries the consequence.
There is also the noiseless reality of stigma. Many children grow up not only managing a medical condition, but navigating a social one. Questions. Isolation. The subtle ways they are made to feel different. By the time some of them come of age, their parents are gone, and they are left to carry both the illness and the weight of survival on their own. This is where the trauma deepens. Not just in the diagnosis, but in the life that follows it.
We must speak more openly about testing. About knowing one’s status before marriage, during pregnancy, and as part of responsible living. We must speak about safe intimacy, not as an abstract moral idea, but as a necessary protection of life. We must ensure that expectant mothers have access to the information and medication required to prevent transmission to their children.
No child should begin life this way. No child should inherit pain that could have been prevented. No child should carry the consequences of silence, denial, or neglect. There is a responsibility that comes with adulthood. A responsibility to protect, to inform, to act. And perhaps that is where this conversation must rest.
Until we confront the silences around HIV, until we make testing normal, until we make prevention and treatment accessible, until we place the child at the centre of our decisions, the cycle will continue. And the echoes will remain, not just in statistics, but in the lives of children who deserved a better beginning.
*A lawyer and equity advocate, Lillian is the publisher of Law & Society Magazine. She can be reached at Lillianokenwa@gmail.com
