At a glance: HIV in Nigeria

The current targets for HIV testing and treatment are called the 95-95-95 targets and must be reached by 2025 in order to end AIDS by 2030.

In 2021 in Nigeria:

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Nigeria has introduced a range of support to help people stay on HIV treatment, including Peer Treatment Champions and Mentor Mothers – and it’s working. Between 2020 and 2021 the percentage of people with HIV who were virally suppressed rose by around 20%. The country has now reached two out of three of the 95 targets, with only the HIV testing target yet to be met.

Preventing HIV in Nigeria focuses on:

• prevention of mother-to-child transmission
• voluntary medical male circumcision (VMMC)
• social and behaviour change communication 
• male and female condoms 
• PEP 
• PrEP (a daily pill is available, vaginal rings and injections are yet to be approved) 
• harm reduction (needle and syringe pilot programmes in three states)
• a range of prevention services for adolescent girls and young women in areas with high HIV prevalence
• testing and treatment for sexually transmitted infections
• links to HIV testing services

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In 2015, Nigeria began addressing gender inequality through its national HIV prevention strategy. Reducing violence and coercion and increasing legal protection for women and girls are focus areas. But progress is slow, hampered by widely entrenched social norms and attitudes, and a lack of data.

Testing for HIV is:

• lower among men and young people than women
• available in health facilities, community spaces, at home (as door-to-door testing or self-testing), workplaces and during testing events
• available through ‘moonlight’ (after-hours) clinics for marginalised communities most-at risk of HIV
• encouraged for couples, and for the partners and children of people newly diagnosed with HIV (called partner notification, sexual network testing and index testing)
• provided as part of tuberculosis and antenatal care
• targeted at population groups that are most vulnerable to HIV, such as sex workers.

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Since 2019 Nigeria has been providing free HIV self-testing kits for population groups most at risk of HIV and the male partners of women with HIV. In 2020, it extended its self-testing programme to include adolescents and young people. Between 2020 and 2023, Unitaid estimated that 2.5 million self-testing kits would be supplied to Nigeria.

Treatment for HIV is:

• available for free, although fees for connected services remains an issue
• available immediately after diagnosis
• available in multi-month refills (for people who are stable on treatment)
• monitored by viral load testing
• available in most health facilities
• available for collection from some community venues, alongside adherence support  (for people who are stable on treatment)
• offered as part of care for tuberculosis, sexually transmitted infections and mental health issues.

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Late diagnosis of HIV is a problem in Nigeria. Around one-third of people are only diagnosed when HIV has progressed to AIDS. So in 2019 Nigeria began offering specialised support for people who start antiretroviral treatment with a low CD4 count.

Due to its large population Nigeria has the biggest HIV epidemic in West and Central Africa, despite having a relatively low HIV prevalence rate. But it is steadily reducing HIV infections, which have fallen by 39% since 2010.

Women are more at risk of HIV than men (1.6% of women have HIV, compared to 1% of men). In 2021, 14,000 young women (ages 15-24) got HIV, compared to 3,600 young men. This difference is driven by gender inequality.

In 2018, 40% of HIV infections in Nigeria occurred among young people (ages 15-24). Only 34% of young men and 43% of young women are fully aware of how to prevent HIV. Recent data from UNAIDS classifies condom use among young women with male partners as very low.

Nigeria has the highest number of annual HIV infections among children in the world (14% of the global total). Progress in this area is slow: between 2010 and 2020 Nigeria reduced mother-to-child HIV transmission by 15%, compared to a 70% reduction in South Africa and Uganda.

In 2014, the Nigerian government increased the punishment for homosexuality to 14 years in jail. Anyone ‘assisting couples’ may face up to 10 years in prison. Sex work and drug use is also illegal. These legal restrictions make it difficult for these criminalised groups to access HIV and other sexual health services. This hinders efforts to reduce the spread of HIV and means that certain marginalised groups are far more at risk of HIV than other people. Although data is limited, in 2014 it was estimated that around 23% of men who have sex with men had HIV. While data released by UNAIDS in 2023, suggested that 16% of sex workers have HIV.

The People Living With HIV Stigma Index (2021) found 20% of people with HIV had experienced HIV-related stigma in the past 12 months, while a 2021 study suggests around 60% of Nigerians hold discriminatory attitudes towards people with HIV. This stops people testing for HIV or accessing treatment if they need it.

Most funding for HIV programming in Nigeria comes from international donors. The government mainly funds health staff. But funding for HIV prevention, care and treatment is reliant on donors, particularly the USA’s PEPFAR programme, which provided the majority of Nigeria’s HIV funding in 2022.