Every day in Nigeria, dozens of children are born with HIV—despite it being preventable. This highlights the ongoing burden of HIV/AIDS on women and children in the country since its first case was reported in 1985.
In 2015, UNICEF estimated that three million people were living with HIV in Nigeria, including 190,950 new infections. This made Nigeria the country with the second-highest HIV/AIDS burden globally.
They also reported that about 260,000 children in Nigeria between the ages of 0 and 14 had HIV with 41,000 of these infections reported as new cases and only 17% of these children had access to antiretroviral medication (ART). This is a result of children having fewer opportunities to receive diagnosis and care. Currently, Nigeria is ranked 33rd with an HIV/AIDS prevalence of 1.3 per cent and the country with the highest prevalence of HIV/AIDS is Eswatini at 27.9 per cent.
The HIV epidemic in Nigeria is widespread, with wide regional and gender differences in prevalence. While children face challenges in accessing treatment, adults in Nigeria also experience significant regional and gender disparities in HIV prevalence.
In 2020, Statista estimated that Nigeria had a total of 1.7 million HIV-positive persons with the prevalence rate at 1.3 percent among adults aged 15-49. Female adults had the highest prevalence rate at 1.6 per cent while male adults had a prevalence rate of 1 per cent.
In 2023, Onovo et al. (2023) in their study using the HIV testing data in Nigeria for all 36 states and capital from October 1, 2020, estimated the national HIV prevalence in Nigeria at 2.1 per cent among adults aged 15-49 years, which equates to approximately 2 million people living with HIV, compared to previous estimates. The modelled HIV prevalence in Nigeria also varied by state, with Benue having the highest prevalence of 5.7 per cent, followed by Rivers at 5.2 per cent, Akwa Ibom at 3.5 per cent, Edo at 3.4 per cent, and Taraba at 3.0 per cent placing fourth and fifth, respectively. Jigawa had the lowest HIV prevalence in the country at 0.3 per cent.
These findings show that women and children are the most vulnerable population in the country as mother-to-child transmission continues to be a major concern. The World Development Indicators by the World Bank estimated that 64 per cent of people living with HIV/AIDs who are aged 15 and older are women with at least 26,000 children infected annually.
Many children born with HIV are as a result of a lack of access to preventive care. The likelihood of an HIV-positive woman spreading the infection to her child are between 15% and 45%. Effective mother-to-child transmission (PMTCT) programs can minimize transmission to neonates to less than 5%. PMTCT services include prevention interventions such as antiviral medication for mothers and babies, proper breastfeeding techniques, and HIV testing for young children.
At least 34 per cent of women living with HIV are receiving antiretroviral therapy in Nigeria. Antiretroviral therapy coverage at the state level is used to assess the effectiveness of the national HIV/AIDS program and identify gaps in care across regions and populations, including adults, pediatrics, and key populations.
To address the burden of this infection on the country’s most vulnerable populations, the complex interplay of socio-cultural, economic and health-related factors must be identified. Deep-rooted gender inequality in the country restricts women’s autonomy and decision-making authority, making it difficult for them to negotiate safe sex and get healthcare. Harmful practices such as early marriage and female genital mutilation make women more vulnerable to HIV infection.
Furthermore, the widespread stigma associated with HIV frequently discourages women from seeking testing and treatment, resulting in delayed diagnosis and development of the disease. Financial constraints can push women into sex work, which is a high-risk occupation with a higher risk of HIV transmission. Limited economic options and financial reliance on men heighten women’s vulnerability. Poverty can also limit access to important healthcare treatments, such as HIV prevention and treatment.
The Nigerian government, together with foreign organizations like UNAIDS and non-governmental organizations (NGOs), has established a number of HIV/AIDS programs. These initiatives prioritize prevention, treatment, and care, including attempts to limit mother-to-child transmission. However, problems such as inadequate funds, limited healthcare facilities, and cultural barriers hinder growth.
Addressing the HIV/AIDS epidemic in Nigeria requires a multifaceted approach that addresses the underlying social, economic, and health disadvantages that women confront. Empowering women through education programs, increasing access to free HIV testing and treatment, and implementing community-led awareness campaigns are critical steps to reducing this burden.
