HIV Prevention in Nigeria: Navigating challenges, strengthening initiatives

The Ifako Ijaiye General Hospital Health Enlightenment Team in a report narrative HIV preventive measures Nigeria should emulate below.

The report states the landscape of HIV, said the Human Immunodeficiency Virus (HIV), was first discovered in 1959 in DR Congo and 1985 in Nigeria and was reported in Nigeria in the year 1986 when a 13-year-old girl and a female sex worker tested positive for the virus.

Almost 4 decades later we have gone through various chapters in the management of HIV in Nigeria. With its vast population and diverse demographics, Nigeria has had her battles with the virus, and with this vast population.

Nigeria has a significant HIV burden (third globally).
Recent statistics reveal that approximately 1.9 million people are living with the virus, underscoring the urgency of robust prevention strategies.

Regional variations persist, emphasizing
the need for targeted interventions in high-prevalence areas.

Key populations, including sex workers, men who have sex with men, and people who inject drugs, face heightened vulnerability, necessitating tailored approaches to address their unique needs.

Despite the challenges: like inadequate awareness, stigma, and uneven access to prevention services persist, and demographic changes, commendable progress has been made in HIV management especially with prevention, though more can still be done.

Prevalence: Nigeria has a significant HIV burden, and prevalence rates vary across different regions and populations. The national prevalence was estimated to be around 1.4% among adults aged 15-49, according to UNAIDS data from 2020.

The first reported prevalence was 1.8% in 1991 and rose as high as 5.8% in 2001, and since then has trended down on account of the various interventions.

Age Distribution: HIV affects individuals across various age groups, but prevalence tends to be higher among adults. Young people, particularly those aged 15-24, are also considered a high-risk group due to factors such as risky behaviors and lack of comprehensive sex education.

Gender Distribution: In Nigeria, as in many other countries, there is a gender disparity in HIV prevalence. The virus often disproportionately affects women, with higher prevalence rates observed among females compared to males.

This gender disparity is influenced by various socio-cultural and economic factors.

The mode of transmission of HIV in Nigeria is primarily driven by heterosexual transmission.

Key affected populations include female sex workers, men who have sex with men, and people who inject drugs, (and these often experience higher prevalence rates due to various factors, including stigma and discrimination).

Other modes of transmission are
Mother-to-child, Sharing of sharps such as blades and needles, transfusion
with un-screened blood, and some unsafe cultural practices.

Primary Prevention: Health Education
Primary prevention remains a key strategy in Nigeria’s fight against HIV.
Educational campaigns constitute a powerful tool to disseminate accurate information, dispel myths, and promote safe practices. Initiatives extend from school-based programs to community outreach and workplace sensitization, ensuring a culture of awareness and responsibility, and upholding the mantra “Undetect able=Untransmittable”.

Campaigns to promote, the ABCs of Contraception (to prevent sexually transmitted diseases): Abstinence for those who are not married, Being faithful to a mutually faithful partner, and Correct, Consistent use of Condoms in Early treatment of Sexually transmitted diseases
Regular voluntary counseling and testing.

Adolescent clinics (staffed by open-minded and youth-friendly staff where teenagers can be educated in a neutral environment about the dangers of early and unprotected sex).

Government agencies, non-profit organizations, and international partners collaborate to implement a complex mix of prevention strategies such as awareness campaigns including social media campaigns, peer education, and community engagement, to reflect a commitment to adaptive strategies to an evolving landscape.

By cultivating an environment of open dialogue and eliminating stigma, primary prevention initiatives empower individuals to make informed choices, promoting treatment adherence and reducing their vulnerability to HIV.

Secondary Prevention:
Early Detection and Comprehensive Management Secondary prevention strategies in Nigeria focus on early detection and effective management of HIV cases.

Voluntary counseling and testing (VCT) services play a pivotal role in encouraging individuals to know their status. Expanding the accessibility of testing centers, particularly in remote areas, is essential to achieving comprehensive coverage.

Prompt initiation of antiretroviral therapy (ART) is a cornerstone of secondary prevention (“test and start”).

Beyond improving the quality of life for those living with HIV, ART significantly reduces the risk of transmission.

Government-led initiatives, supported by international collaborations, aim to enhance ART coverage and access to treatment. Differentiated service delivery models, community-based programs, and task-shifting approaches contribute to reaching diverse populations and improving adherence to treatment regimens.

Adequate and proper nutrition including early detection and treatment of other medical conditions that an infected person may come down with is a very important aspect of secondary prevention.

Other preventive measures Support system either within the family and/or a knowledgeable group of people.