The first two HIV cases in Nigeria were identified in 1985 and were reported at an international AIDS conference in 19866. In 1987 the Nigerian health sector established the National AIDS Advisory Committee, which was shortly followed by the establishment of the National Expert Advisory Committee on AIDS (NEACA).
At first the Nigerian government was slow to respond to the increasing rates of HIV transmission7 and it was only in 1991 that the Federal Ministry of Health made their first attempt to assess the Nigerian HIV/AIDS situation. The results showed that around 1.8 percent of the population of Nigeria were infected with HIV. Subsequent surveillance reports revealed that during the 1990s the HIV prevalence rose from 3.8% in 1993 to 4.5% in 19988.
A poster encouraging sexual abstinence in Nigeria
When Olusegun Obasanjo became the president of Nigeria in 1999, HIV/AIDS prevention, treatment and care became one of the government’s primary concerns. The President’s Committee on AIDS and the National Action Committee on AIDS (NACA) were created, and in 2001, the government set up a three-year HIV/AIDS Emergency Action Plan (HEAP). In the same year, Obasanjo hosted the Organisation of African Unity’s first African Summit on HIV/AIDS, Tuberculosis, and Other Related Infectious Diseases9.
Despite these positive intentions for tackling the epidemic, in 2006 it was estimated that just 10 percent of HIV-infected women and men were receiving antiretroviral therapy and only 7 percent of pregnant women were receiving treatment to reduce the risk of mother-to-child transmission of HIV10.
How is HIV transmitted in Nigeria?
Some 80% of HIV infections in Nigeria are transmitted through heterosexual sex. Factors contributing to this include a lack of information about sexual health and HIV, low levels of condom use and high levels of sexually transmitted infections (STIs) such as chlamydia and gonorrhoea, which make it easier for the virus to be transmitted.
It has been reported that blood transfusions account for up to 10 percent of new HIV infections in Nigeria11. There is a high demand for blood because of blood loss from surgery and childbirth, road-traffic accidents and anaemia and malaria. Not all Nigerian hospitals have the technology to effectively screen blood and therefore contaminated blood is often used. The Nigerian Federal Ministry of Health have responded by backing legislation that requires hospitals to only use blood from the National Blood Transfusion Service, which has far more advanced blood-screening technology12.
The other main transmission route is mother-to-child transmission. In 2005 it was estimated that 220,000 children were living with HIV, most of whom became infected from their mothers13.
Factors contributing to the spread of HIV in Nigeria
Lack of sexual health information and education
Sex is traditionally a very private subject in Nigeria and the discussion of sex with teenagers is often seen as inappropriate. Up until recently there was little or no sexual health education for young people and this has been a major barrier to reducing rates of HIV and other STDs. UNAIDS estimate that only 18 percent of women and 21 percent of men between the ages of 15 and 24 correctly identify ways to prevent HIV14. Lack of accurate information about sexual health has meant there are many myths and misconceptions about sex and HIV, contributing to increasing transmission rates as well as stigma and discrimination towards people living with HIV/AIDS.
Doctors seeing patients in an HIV clinic in Nigeria
Another contributing factor to the spread of HIV in Nigeria is the distinct lack of voluntary and routine HIV testing. In a 2003 survey, just 6 percent of women and 14 percent of men had ever been tested for HIV and received the results15. In 2005, only around 1 percent of pregnant women were being tested for HIV16.