Fatmata’s life took a dramatic turn when she lost her husband and father to their beautiful 5 year old daughter, Amira. Apart from living with the pain of losing a loved one, Fatmata also found out she was HIV positive, a condition which she to date thinks took a toll on her husband’s health and led to his demise.
“When I was diagnosed as HIV positive, I was sad, angry, confused and unsure about what to do next. This was only a few months after I lost my husband to some strange ailment. I did not have a lot of information about this condition and was afraid that being a widow with little resources, taking a lifelong medication would be too expensive,” she recalls.
Fatmata’s fears reflect the reality for many in Sierra Leone, where the most recent data (2024) from the National AIDS Secretariat (NAS) indicates an HIV prevalence rate of 1.7% among people aged 15 to 49. Women bear the brunt of the epidemic, with a prevalence rate of 2.2%, compared to 1.1% among men.
Among high-risk groups, the statistics are even more alarming. Female sex workers have an HIV prevalence of 11.8%, while people who inject drugs and transgender individuals each report rates of 4.2%. Men who have sex with men (3.2%) and prisoners (3.7%) also face significant risks.
In total, 77,000 people in Sierra Leone are living with HIV, including over 70,000 adults and more than 6,700 children aged 0 to 15. Youths aged 10 to 25 make up 13,000 of these cases, highlighting the urgent need for targeted prevention efforts. According to the NAS, in 2024 alone, there were 3,500 new infections and 2,300 AIDS-related deaths across all ages, underscoring the epidemic’s continuing toll.
Fatmata says the transition from the point she was diagnosed to the point she is now taking her Antiretroviral Treatment (ART) was a tough journey. Initially, she confided only in her mother, who encouraged her to seek help. Today, she regularly visits the George Brook Community Health Centre in Dwazark, where HIV counselor Alusine Aaron Jibao provides care and support.
Jibao is responsible for dispensing of ARVs to more than 364 clients who are within his database. He is happy that the consistent and timely supplies of ARVs from the District Health Management Team has helped boost compliance of patients who visit George Brook CHC to receive their monthly supply of either adult ARVs, pediatrics ARVs or for prophylaxis medications such as Cotrimoxazole.
For Fatmata, ART has been life-changing.
“I disclosed my status to my new husband and older children. They remind me to take my ARVs and support me in managing my condition,” she says. It has also prevented transmission to her new husband and child, giving her family’s hope for a healthy future.
However, for Fatmata and people living with HIV/Aids, stigma remains a significant barrier. Fatmata acknowledges the shame she initially felt but is now empowered to live openly. Her counselor, Jibao, notes that many clients over the years have now gained the confidence to refer friends and partners for testing and treatment.
“Breaking the stigma starts with education and providing a supportive environment,” he says.
The NAS, under the leadership of Director General Abdul Rahman Chernoh Sessay, is at the forefront of Sierra Leone’s response to HIV/AIDS. “The 2024 data shows the burden of HIV continues to fall disproportionately on women and high-risk groups. This underscores the need for targeted interventions and equitable resource allocation,” Sessay emphasizes.
In Sierra Leone’s 2025 budget, total allocations to the health sector stand at NLe 1,466,120 billion, representing 9% of the total budget. The allocation for HIV/AIDS-related issues represents less than 0.5% of the total health sector budget each year. This suggests that HIV/AIDS programs may rely heavily on external funding, such as contributions from global initiatives like the Global Fund, rather than being prioritized in domestic health budgets.
Given the high prevalence rates among certain demographics and the ongoing need for ARV distribution and community outreach, the allocation could benefit from an increase to better meet the country’s needs.
Partnerships with organizations like the Global Fund for TB, AIDS and Malaria have been critical in ensuring free ART for those in need. UNICEF has also been instrumental in distributing essential medical supplies, ensuring no stockouts at health facilities. Quarterly distribution of ARVs to community health centers and regular training for healthcare workers have strengthened the system’s capacity to deliver care.
Director General Sessay is optimistic about the future:
“Every life is valuable, and we are committed to ensuring no one is left behind. By focusing on prevention, treatment, and education, we can continue to reduce the burden of HIV in Sierra Leone.”
About 43 years ago, Los Angeles physician Dr. Michael Gottlieb and colleagues published the first medical account of what would eventually become known as AIDS. It was a short summary in the Centers for Disease Control and Prevention’s printed weekly newsletter of five cases of pneumonia in gay men, all of whom eventually died. The global story that has unfolded since is an unspeakable tragedy. HIV/AIDS has claimed more than 32.7 million lives, dwarfing the toll of the COVID-19 pandemic.
Meanwhile, Fatmata now dreams of starting a small business to support her family and show her children that their mother is strong and capable.
“I want to be a role model for my daughter,” she says with determination.
Her journey from despair to empowerment is a testament to the transformative power of access to healthcare, family support, and resilience. Fatmata’s life may have been altered by HIV, but it has not been defined by it.
