While Nigeria accounts for 4.5% of the global HIV burden, the story behind its epidemic is one of both significant challenges and hopeful progress, as revealed by its complex statistics.
Key Takeaways
- In 2022, Nigeria had an estimated 1.8 million people living with HIV
- Adult HIV prevalence in Nigeria was 1.4% in 2022 among 15-49 year olds
- New HIV infections in Nigeria totaled 76,000 in 2022
- Women 15-49 HIV prevalence 1.6% vs men 1.1% in 2022
- Females account for 62% of PLHIV in Nigeria 2022
- HIV prevalence among women 1.9% vs 1.0% men in 2018 NDHS
- HIV testing coverage among adults 15-49 was 25% in 2018 NDHS
- 85% of diagnosed PLHIV knew status by end 2022
- PMTCT testing coverage 92% pregnant women 2021
- ART coverage reached 82% among diagnosed adults 2022
- 1.5 million on ART in Nigeria end 2022
- Viral suppression among PLHIV on ART 68% 2022
- Condom use at last sex 85% FSW, 45% general population 2018 NDHS
- PrEP initiations 50,000 key populations 2022
- Voluntary medical male circumcision coverage 25% eligible men 2022
Despite a declining national rate, Nigeria's HIV epidemic remains severe and disproportionately affects women.
Demographics
- Women 15-49 HIV prevalence 1.6% vs men 1.1% in 2022
- Females account for 62% of PLHIV in Nigeria 2022
- HIV prevalence among women 1.9% vs 1.0% men in 2018 NDHS
- Youth females 15-24 prevalence 1.2% vs males 0.5% 2022
- Children 0-14 living with HIV: 110,000 in 2022
- Elderly 50+ HIV prevalence 2.5% in some states 2018
- Adolescents girls 10-19 account for 25% new infections
- Male PLHIV 690,000 vs female 1.1 million 2022
- Rural women prevalence 1.4% vs urban 2.0% 2018
- Northern region low prevalence 0.6% but high population impact
- South-South highest female prevalence 4.1% 2018
- 45% PLHIV are of reproductive age 15-49 2022
- Gender disparity: women 2x more affected than men
- Children <15 represent 6% of PLHIV 2022
- Urban males prevalence 1.3% vs rural 0.9% 2018 NDHS
- Pregnant women demographics show 70% in low-prevalence states
- FSW median age 25 years with HIV prevalence peaking 25-29
- MSM age 18-24 highest new infections subgroup
- PWID mostly males 90% HIV positive cases 2021
- 1.1 million women of childbearing age living with HIV
- Adolescents 10-19: 200,000 PLHIV estimated 2022
- North-East low female prevalence 0.8% due to conflict
- Highest burden states: Akwa Ibom 80,000 PLHIV mostly adults
- 55% PLHIV female in high-prevalence states 2018
- Youth 20-24 females 1.8% prevalence peak
- Male truck drivers 35-44 age group 5% prevalence
- 70% PLHIV aware of status in urban demographics 2022
Demographics Interpretation
While men seem to be playing a disappointing game of catch-up, the data shouts that Nigeria's HIV epidemic is a glaring, gendered inequality, disproportionately saddling women and girls from adolescence to old age with the greater burden of infection, vulnerability, and care.
Prevalence and Incidence
- In 2022, Nigeria had an estimated 1.8 million people living with HIV
- Adult HIV prevalence in Nigeria was 1.4% in 2022 among 15-49 year olds
- New HIV infections in Nigeria totaled 76,000 in 2022
- HIV incidence rate in Nigeria was 0.39 per 1,000 uninfected population in 2022
- Nigeria accounted for 4.5% of global HIV burden in 2022
- States like Akwa Ibom had HIV prevalence of 5.6% in 2018 NASCP survey
- Benue state HIV prevalence was 6.2% in adults per 2018 data
- Lagos state adult HIV prevalence 1.4% in 2018
- HIV prevalence in Rivers state was 3.7% per 2018 survey
- National HIV prevalence dropped from 1.8% in 2018 to 1.4% in 2022
- 54,000 AIDS-related deaths in Nigeria in 2022
- HIV prevalence among pregnant women was 0.98% in 2021 PMTCT data
- Key population HIV prevalence averaged 4.2% in 2021 IBBS
- Female sex workers in Nigeria had 6.5% HIV prevalence in 2021
- Men who have sex with men HIV prevalence 12.2% per 2021 IBBS
- People who inject drugs HIV prevalence 8.9% in select states 2021
- HIV incidence among adults 0.4% in 2020 modeling
- Regional prevalence highest in South-South Nigeria at 3.1%
- North-Central zone prevalence 2.0% per 2018 data
- South-East HIV prevalence 1.9% adults 2018
- 1.3 million women living with HIV in Nigeria 2022
- Projected HIV prevalence to decline to 1.0% by 2030 if trends continue
- Urban areas HIV prevalence 1.6% vs rural 1.1% in 2018
- Youth 15-24 HIV prevalence 0.9% nationally 2022
- Annual new infections declined 25% from 2010-2022
- HIV burden 2nd highest in West/Central Africa 2022
- 2023 NACA report: 1.7 million PLHIV estimated
- Prevalence in truck drivers 4.3% per IBBS 2021
- Mobile populations HIV prevalence 3.2% 2021
- Antenatal clinic sentinel surveillance shows 1.0% prevalence 2022
Prevalence and Incidence Interpretation
While the national trend is cautiously moving in the right direction, Nigeria's fight against HIV is a story of two realities: a declining overall prevalence that masks severe, persistent epidemics concentrated in specific regions and among key populations who are being left dangerously behind.
Prevention and Behavior
- Condom use at last sex 85% FSW, 45% general population 2018 NDHS
- PrEP initiations 50,000 key populations 2022
- Voluntary medical male circumcision coverage 25% eligible men 2022
- Comprehensive condom programming distributed 200 million 2022
- PMTCT coverage prevented 50,000 infections in infants 2022
- Behavior surveys show multiple partners 15% adults 2018
- Needle syringe program reached 100,000 PWID 2021
- HIV knowledge 75% comprehensive among youth 15-24 2018
- OST coverage 20% PWID 2021 IBBS
- Age-disparate sex 25% adolescent girls 2018 NDHS
- 500 DREAMS program sites for AGYW prevention 2022
- Transactional sex 35% women 15-24 reported 2018
- VMMC 2.5 million procedures since 2013
- Contraceptive use among HIV+ women 45% 2021
- Stigma index shows 40% discrimination PLHIV 2021
- Safe injection practices 90% health facilities audited
- Peer education reached 5 million youth 2022
- PrEP awareness 30% MSM, 20% FSW 2021 IBBS
- Blood safety 99% screened units 2022
- Mother-to-child transmission rate reduced to 4.5% 2022
- Abstinence/delayed sex 60% youth reported 2018
- Harm reduction programs in 15 states for PWID
- 95% schools HIV education integrated curriculum
- Consistent condom use general pop 20% last high-risk sex
- AGYW DREAMS reached 300,000 girls 2022
Prevention and Behavior Interpretation
Nigeria’s HIV response is a striking landscape where remarkable biomedical progress, like averting 50,000 infant infections, coexists with stubborn behavioral gaps, as the general population's 20% consistent condom use in risky encounters reveals a perilous chasm between program achievement and personal practice.
Testing and Diagnosis
- HIV testing coverage among adults 15-49 was 25% in 2018 NDHS
- 85% of diagnosed PLHIV knew status by end 2022
- PMTCT testing coverage 92% pregnant women 2021
- Key populations tested: FSW 78%, MSM 65%, PWID 55% in 2021 IBBS
- National HIV testing services reached 27 million tests 2022
- Self-testing kits distributed 1.2 million in 2022
- Index testing identified 150,000 positives 2022
- Community testing uptake 40% among youth 2022
- Facility-based testing 70% of total HTS 2022
- Testing positivity rate 1.5% nationally 2022
- Partner notification testing yield 5% positives 2021
- 95-95-95 first 95% (diagnosis) at 85% achievement 2022
- Mobile testing units conducted 500,000 tests in hard-to-reach areas
- School-based HIV testing reached 100,000 adolescents 2022
- Viral load testing before diagnosis confirmation 90% facilities
- TB/HIV collaborative testing 80% TB patients tested 2022
- Testing in prisons reached 60% inmates 2021
- Hotline HIV testing referrals 50,000 calls 2022
- EID testing for HEIs 95% within 48 hours target
- Recency testing implemented in 10 states 2022
- Youth-friendly testing centers 200 operational 2022
- Testing coverage FSW increased to 82% from 70% 2018-2021
- MSM testing barriers reduced by 20% via peer outreach 2022
- 30 million tests cumulatively 2019-2022 under GF grant
- Diagnosis gap closed to 15% of PLHIV undiagnosed 2022
- ART initiation same day testing 75% facilities 2022
- 92% of pregnant women tested at first ANC 2021 PMTCT
- HIV testing in emergency departments 50% coverage 2022
- 1.4 million diagnosed PLHIV out of 1.8 million 2022
Testing and Diagnosis Interpretation
Nigeria's HIV testing efforts paint a picture of impressive, targeted reach in clinics and among pregnant women, yet the nation still wrestles with the stubborn first hurdle of the 95-95-95 targets, as a quarter of adults remain untested and a chasm exists between the general population and the commendable strides made with key groups.
Treatment and ART
- ART coverage reached 82% among diagnosed adults 2022
- 1.5 million on ART in Nigeria end 2022
- Viral suppression among PLHIV on ART 68% 2022
- 95-95-95 second 95% (treatment) at 82% 2022
- Pediatric ART coverage 35% among children living with HIV 2022
- Dolutegravir transition 90% first-line regimens 2022
- ART retention at 12 months 85% nationally 2021
- 1,200 health facilities providing ART services 2022
- PMTCT ART coverage 94% HIV+ pregnant women 2021
- Community ART groups 50,000 members multi-month dispensing
- Viral load testing coverage 45% on ART >12 months 2022
- TB preventive therapy 60% PLHIV on ART 2022
- Differentiated service delivery models in 80% states
- Second-line ART 45,000 patients 2022
- ART initiation within 7 days diagnosis 90% 2022
- 300,000 new ART enrollments 2022
- Viral suppression women 70% vs men 65% 2022
- Children on ART increased 20% 2021-2022
- Multi-month scripting 6 months 40% stable patients 2022
- ART stockouts reduced to <5% facilities 2022
- 95% third 95% (suppression) at 68% 2022 gap
- Key pop ART coverage FSW 65%, MSM 55% 2021
- Adolescent ART retention 75% at 24 months
- Fixed-dose combinations 95% pediatric formulations available
- LTFU rate 10% first year on ART 2021
- 2 million ART courses procured 2022 GF/PEPFAR
- Viral load monitoring labs 50 operational 2022
- Pre-ART CD4 testing 80% before initiation
- PMTCT Option B+ 98% uptake among positives 2021
Treatment and ART Interpretation
While Nigeria's adult ART program is impressively scaling the cliff face towards the 95-95-95 targets, we must urgently toss a much longer rope to the children and key populations lagging dangerously behind.
Sources & References
- Reference 1UNAIDSunaids.orgVisit source
- Reference 2AIDSINFOaidsinfo.unaids.orgVisit source
- Reference 3NACAnaca.gov.ngVisit source
- Reference 4NCBIncbi.nlm.nih.govVisit source
- Reference 5THELANCETthelancet.comVisit source
- Reference 6DHSPROGRAMdhsprogram.comVisit source
- Reference 7WHOwho.intVisit source
- Reference 8THEGLOBALFUNDtheglobalfund.orgVisit source
- Reference 9USAIDusaid.govVisit source