Nigeria faces a public health challenge with HIV. The country carries a substantial portion of the global HIV burden, particularly within West and Central Africa. Despite ongoing efforts, HIV continues to affect many citizens across various demographics and communities. Understanding HIV in Nigeria involves examining its current distribution, contributing factors, and ongoing responses to mitigate its impact.
Current Situation
Nigeria has one of the largest HIV epidemics globally, with an estimated 1.9 million people living with HIV as of 2021. The adult HIV prevalence rate is approximately 1.3%. Despite this relatively low prevalence, Nigeria’s large population results in a high absolute number of affected individuals, making it the country with the fourth highest HIV burden worldwide.
In 2021, new HIV infections totaled about 74,000, and AIDS-related deaths reached 51,000. Women are disproportionately affected, with a prevalence rate of 1.6% compared to 1.0% in men. Young women aged 15-24 accounted for 14,000 new HIV infections in 2021, significantly higher than the 3,600 among young men in the same age group. Children also face a substantial burden, with Nigeria accounting for the highest number of annual HIV infections among children globally, representing 14% of the world’s total.
The epidemic shows regional variations. For instance, the South-South geopolitical zone reported the highest prevalence at 3.1% in 2018. Key populations, such as men who have sex with men and sex workers, also experience higher prevalence rates, with estimates around 23% among men who have sex with men in 2014 and 16% among sex workers in 2023.
Factors Contributing to Spread
Several socio-economic factors contribute to the spread of HIV in Nigeria. Gender inequality plays a substantial role, evidenced by higher HIV rates among young women compared to young men. This disparity links to societal norms that may limit women’s ability to negotiate safer sexual practices or access prevention resources. Limited awareness about HIV prevention methods among young people also contributes; only 34% of young men and 43% of young women are fully informed.
Cultural practices and social norms also hinder prevention efforts. For example, recent data indicates very low condom use among young women with male partners. Stigma and discrimination associated with HIV remain significant barriers, with approximately 20% of people living with HIV reporting experiences of stigma in 2021. A 2021 study suggested that around 60% of Nigerians hold discriminatory attitudes towards individuals with HIV, which can discourage testing and accessing treatment.
Weaknesses in healthcare infrastructure and limited access to services further complicate the response. While millions have been tested for HIV, general population testing approaches have yielded low positivity rates, indicating inefficiencies in identifying new cases. Only a fraction of children living with HIV had access to antiretroviral therapy in 2015, highlighting gaps in pediatric care.
National Efforts and Progress
The Nigerian government, in collaboration with international partners, has implemented various strategies to combat HIV. National programs focus on increasing access to prevention, treatment, and care services. A milestone was the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) conducted in 2018, the world’s largest HIV survey. This survey provided more accurate data, revealing a national adult prevalence of 1.3% among individuals aged 15-49, an improvement from 3.4% in 2012.
Progress includes a 39% decline in new infections since 2010. The country has also expanded access to antiretroviral treatment (ART), with 1.7 million people on ART in 2021. Efforts align with global targets, such as the 90-90-90 goals: 90% of people living with HIV know their status, 90% of those diagnosed are on ART, and 90% of those on ART achieve viral suppression.
Initiatives include strengthening community-led service delivery, with a review of the National HIV/AIDS Community Care and Support Guidelines underway. Vulnerable populations, including people living with HIV and key populations, are being linked to economic empowerment programs. These approaches address both the medical and social aspects of the epidemic.
Persistent Challenges
Despite progress, Nigeria faces several persistent challenges in its fight against HIV. Stigma and discrimination remain significant hurdles, deterring individuals from seeking testing and treatment. This societal prejudice can lead to delayed diagnosis and poor adherence to treatment, undermining public health efforts. The fear of social ostracism often outweighs the benefits of early intervention for many.
Funding gaps represent another major obstacle. Most funding for HIV programming in Nigeria originates from international donors, with the government primarily funding health staff. This reliance on external support can create vulnerabilities in program sustainability and expansion, especially if donor priorities shift. Ensuring consistent and adequate domestic funding is necessary for long-term success.
Infrastructure limitations also impede effective service delivery. While ART access has improved, ensuring equitable distribution across all regions and populations remains a challenge. Remote and underserved areas often lack the necessary healthcare facilities, trained personnel, and supply chain logistics to provide comprehensive HIV services. This disparity in access can exacerbate health inequalities.