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HIV IN NIGERIA

Health Impact of HIV in Nigeria

Mariah Little

Delaware Technical Community College

NUR310

Mrs. Hines

April 18, 2021

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HIV IN NIGERIA

Abstract

Human immunodeficiency virus (HIV) is prevalent and a critical health challenge in Nigeria

today. HIV has played a significant role in the lives of the citizens in Nigeria. This paper

explores the factors that put the Nigerian citizens more at risk for developing a deadly virus if

treatment measures are not implemented. Highlighting the importance of medication

management with antiretroviral therapy and educational resources to enable more citizens to not

fear treatment and the importance of preventative measures for the uninfected.
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Health Impact of HIV in Nigeria

Nigeria has a total population of 195.9 million people. From the 2018 statistics 67% of

the population knowingly is living with human immunodeficiency virus [HIV] (WHO, 2018).

HIV is a virus that attacks the body’s immune system essentially and weakens the ability for

someone’s body to fight infection. Unfortunately, HIV is an incurable disease (HIV.gov, 2020).

It is spread through bodily fluids of an infected HIV individual. Specifically, through dirty

needles and unprotected sexual intercourse. Subsequently, HIV can lead to acquired

immunodeficiency syndrome (AIDS) when left untreated (HIV.org, 2020). There is treatment to

weaken the virus in one’s body to prevent transmission and it enables people with HIV to live a

longer healthier life (HIV.org, 2020). Since the HIV pandemic began in the 1980’s, Africa has

seen to distinctly been majorly impacted by the epidemic. There have been distinctive reasons

but no certain answer.

Socioeconomic Factors

High rates of poverty, access to clean water and sanitation, educational resources, gender

inequality, and more all play a role in to the culture and social determinants of health involving

HIV in Nigeria. In 2015, 57 million lacked access to improved water sources, 130 million

Nigerian’s were without proper sanitation, and 25% of Nigerian’s practice open defecation every

day (UNICEF, n.d.a). The decreased sanitation measures allow a higher risk for acquiring

bacteria and viruses and open defecation puts individuals more vulnerable to sexual abuse. 67%

of children in Nigeria do not attend school, lacking crucial educational resources. More boys

attend school than girls in Nigeria (UNICEF, n.d.a). The ongoing abuse can play a significant

role into the number of children attending school. 6 out of 10 children reported they have been a

victim of some type of abuse before the age of 18 and 70% of those 6 have been subjected to
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abuse more than once (UNICEF, n.d.a). Educating children at school on what HIV is, condom

use, preventative measures and more is an effective way to help in decreasing the spread. With

kids not attending school this vital conversation is missed. Nigeria has a high prevalence of child

brides, with more than 23 million married as a young girl (UNICEF, n.d.b). Female mutilation is

still performed in Nigeria, about 19.9 million have undergone female genital mutilation

(UNICEF, n.d.b). Females are forced into marriage at a young age and usually their families pick

their husband, this enables the opportunity for exposure to HIV. 83 million Nigerians are

reported to live below the poverty line, with another 53 million right above it (World Bank,

2020). Reducing poverty can allow for better treatment and preventative measures. Nigeria is

also reported one of the top 5 countries with record numbers of neonatal death (Ataguba et al.,

2016). In Nigeria, only 18% of the children between 6 to 23 months receive adequate meals to

fulfill their nutritional needs (UNICEF, n.d.c). Nigeria discourages and punishes men who have

sex with men. In 2017 the percentage of men who have sex with other men was at 23%. In 2014,

Nigerian government increased the sentence of same sex relationships to 14 years in prison and

if found assisting any couples in homosexuality, people can face 10 years in prison (Avert,

2020). This can make it difficult to treating and reaching the LGBQT community in Nigeria, as

they fear of punishment if caught. People who inject drugs are vulnerable to infections,

especially HIV. 9% of new HIV infections every year are contributed to transmission through

injection of drugs (Avert, 2020).

Changing the Context

Many organizations have been making strides to improve the HIV prevalence and health

determinants in Africa and are making significant progress. In Nigeria it is important to analyze

ways to stop and prevent the further spread of HIV. Incorporating ideas and ways to make
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nothing but safe practices available is fundamental. If we eliminate all unsafe sanitation practices

and incorporate more private restrooms and safe water sources, individuals have no option but to

choose the more secure and sanitized water sources. Through UNICEF, 1.7 million Nigerian

citizens now have access to improved water sources. Now 1.7 million Nigerians that were at

increased risk for infections through unsafe water have eliminated their risk (UNICEF, n.d.d).

Another way to aim at changing the context is to push universal condom use by everyone. If

condoms are dispersed everywhere and made second nature, the spread of HIV could be greatly

decreased. 2017 data revealed 57.6% of men reported condom use while 39.8% of women

reported using a condom in sexual intercourse (Avert, 2020).

Long-Lasting Protective Interventions

Unfortunately, there is no vaccine for HIV but there is hope that maybe one day there

will be. Immunization is an excellent way for long lasting-preventative intervention. The practice

of circumcision among men could be an excellent preventative intervention. In trials performed

in Africa they discovered a 60% protective effect from HIV in heterosexual circumcised males

(Prodger & Kaul, 2017). Unfortunately, the preventative factor is not the same for men who sex

with men as they know it is less than 60% but are unsure of the percentage of protective effect

for them (Yuan et al., 2019).

Clinical Interventions

Clinical interventions are among the core of HIV/AIDS treatment in Nigeria. Of the 67%

knowingly living with HIV, 53% of them are receiving antiretroviral therapy (WHO, 2019).

Nigeria has a target goal of enrolling 90% of HIV positive individuals into antiretroviral therapy

treatment (Avert, 2020). Antiretroviral therapy is used to decrease the viral load in someone with
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HIV and make their load so low that it can be considered undetectable. Antiretroviral therapy

reduces the ability for the virus to replicate, restores CD4 immune cells that are destroyed by the

virus, decrease complications from HIV, and prevent the transmission to others (Carter, 2019).

When individuals are started on antiretroviral therapy it is crucial for them to be compliant and

continue treatment, else they cannot achieve a low viral load. HIV infected pregnant women

should enroll in antiretroviral therapy during their pregnancy to prevent transmission to the

newborn child. It should also be standard to test pregnant women for HIV, as in 2016 only 34.7%

had an HIV test performed (Avert, 2020). Nigeria currently faces difficulties being able to

sustain stock of antiretroviral therapy for patients (Avert, 2020). For citizens not infected with

HIV but nervous about the risk due to potential for rape and more the use of pre-exposure

prophylaxis is a good way to prevent the transmission. Pre-exposure prophylaxis is currently not

available to the citizens of Nigeria. Funding should be made or analyzed on how they can make

this preventative measure available to especially drug injection users, people who engage in anal

sex, sex workers, and serodiscordant couples (Avert, 2020).

Counseling and Educational Interventions

Educational practices may seem little but in the transmission of HIV in Nigeria, go a long

way. In a survey to individuals on their knowledge of HIV and transmission 60.7% displayed

knowledge of condom use to prevent transmission, 56.6% displayed knowledge of transmission

during pregnancy, 55.4% displayed knowledge of transmission during delivery, and 64.2%

displayed knowledge of transmission through breastfeeding (Yaya et al., 2019). Incorporating

proper condom use and importance for prevention of transmitting or acquiring HIV should be

implemented in schools, doctor’s offices, newspapers, and more. Until 90% or more of the

population can demonstrate proper knowledge on HIV and transmission more education needs to
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be carried out. Educating moms during pregnancy on importance of adherence with antiretroviral

therapy and being seen and delivered in a healthcare facility plays a huge role in the prevention

of her newborn becoming infected. Breaking the barrier of attitude towards HIV infection is also

important to allow people to be more open to receiving care. When media sources displayed

information regarding HIV stigma had been shown to decline. If we keep portraying HIV

treatment and recognition as a norm than more citizens will be receptive to seeking health care

(Yaya et al, 2019).

Conclusion

The prevalence of HIV in Nigeria has come a long way since the first reported case in

1986. Although there have been great strides, there is much more room for improvement. If at a

socioeconomic level, we can address concerns and promote and enable safe sanitation and

defecation we can prevent the further spreading of the virus. Reducing the poverty can also aid in

the services citizens are able to receive and can decline the infection rates. Making condom use a

normalcy is also crucial in prevention. While a vaccine is still not likely, educating more citizens

on circumcision can aid in infection rates. More citizens that are in active treatment of

antiretroviral therapy increases life expectancy in someone with HIV and prevents the spread to

noninfected individuals. The use of pre-exposure prophylaxis amongst the high-risk population is

something the Nigerian government should be open to funding. Enhanced targeted education at

the high-risk population group about HIV and ways to prevent becoming infected. Promoting

gender equality and discouraging the negative image that infected men who engage in sex with

other men are less worthy than heterosexual men can increase the susceptibility for them to

receive care. Focusing on making easy availability for people to get tested can also increase the

diagnosis and treatment of citizens. Every aspect helps and contributes to another. First if we
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push sanitation and adherence of kids to attend school, we can execute and be able to educate

more citizens starting at a early age. Once we improve one it can lead to the improvement of

another, and the infection rates can begin to decrease as treatment levels increase. It is a step-by-

step process and each benefits the other, but with help of many organizations and even current

citizens of Nigeria, the future is bright for the epidemic of HIV.

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