The Nigerian socio-political environment has long been hostile and intolerant towards men who have sex with men (MSM) and the passing of the Same Sex Marriage Bill has had additional negative consequences. Numerous cases of arrests and homophobic violence against MSM have been reported and this has subsequently driven MSM further away from mainstream healthcare services. Participants reported that during ‘adherence counselling’, they were advised about the basic mechanisms of antiretroviral treatment (ART) and how to manage their illness with ART. The majority of participants stated that they took their ART once per day and it was usually at night, however, two reported that they took theirs twice a day because they were on a second line treatment regimen. The general consensus among participants was that consistent use of ART offered an abundance of health benefits. A particular problem for some participants was the difficulty of taking ART at a set time every day for the rest of their lives.