The first two cases of HIV and AIDS in Nigeria were identified in 1985 and were reported at an international AIDS conference in 1986. 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 transmission and it was only in 1991 that the Federal Ministry of Health made their first attempt to assess Nigeria’s AIDS situation. The results showed that around 1.8 percent of the population of Nigeria was infected with HIV. Subsequent surveillance reports revealed that during the 1990s HIV prevalence rose from 3.8% in 1993 to 4.5% in 1998.
When Olusegun Obasanjo became the president of Nigeria in 1999, HIV 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 Organization of African Unity’s first African Summit on HIV/AIDS, Tuberculosis, and Other Related Infectious Diseases.
In 2005 a new framework was developed covering the period from 2005 to 2009.
Despite increased efforts to control the epidemic, by 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 HIV.
In 2010 NACA launched its comprehensive National Strategic Framework to cover 2010 to 2015, which requires an estimated N756 billion (around USD 5 billion) to implement. Some of the main aims included in the framework are to reach 80 percent of sexually active adults and 80 percent of most at-risk populations with HIV counseling and testing by 2015; ensure 80 percent of eligible adults and 100 percent of eligible children are receiving ART by 2015; and to improve access to quality care and support services to at least 50 percent of people living with HIV by 2015.
Despite being the largest oil producer in Africa and the 12th largest in the world, Nigeria is ranked 158 out of 177 on the United Nations Development Program (UNDP) Human Poverty Index. This poor development position has meant that Nigeria is faced with huge challenges in fighting its HIV and AIDS epidemic.
KEY STATISTICS ON HIV IN NIGERIA
- Currently HIV prevalence among the general population is 3.6%.
- National median prevalence among pregnant women is 4.1%.
- About 3.1 million people are living with HIV in Nigeria.
- About 300,000 new infections occur annually with people aged 15 – 24 contributing 60% of the infections.
- 1.5 million People living with HIV require ARVs using the new WHO guidelines.
- Only 30% of people living with HIV who need antiretroviral (ARVs) have access to it.
- Less than 30% of pregnant women have access to PMTCT services.
WOMEN, GIRLS AND HIV
- HIV is the leading cause of death and disease among women of reproductive age (15 – 49years).
- In sub- Saharan African, 60% of the People Living with HIV is female (while women make up 50% of the global epidemic).
- In Nigeria prevalence among young women aged 15 – 24 years is estimated to be three times higher than among men of the same age.
- Females constitute 58% (about 1.72 million) of persons living with HIV in Nigeria.
- Each year, 55% of AIDS deaths occur among women and girls.
VIOLENCE AGAINST WOMEN AND GIRLS IS A KEY DRIVER OF HIV EPIDEMIC
- Forced sex increases the risk of HIV transmission among women due to tears and lacerations.
- Worldwide up to 70% of women experience violence in their lifetime.
- Women, fearing or experiencing violence, are less likely to negotiate for safe sex, go for HIV testing, share their HIV status and access treatment.
- 28% of women has experienced physical violence by age 15.
- A total of 45% of violence against women are perpetrated by their current husbands or parents.
- 45% of women who ever experience physical or sexual violence did not seek help from any source or tell anyone about the violence.
GENDER INEQUALITY AND WOMEN & GIRLS VULNERABILITY TO HIV IN NIGERIA
Why gender inequality makes women and girls vulnerable to HIV:
- Women and girls lack the power to control key aspects of their lives including marriage and sexual negotiation in and out of marriage.
- Women and girls may also lack the social and economic power to control the impact of the epidemic in their lives.
- They may also lack access to education, personal income and property rights.
- Low literacy, lack of access to health information and low seeking behavior.
- Cultural/traditional male dominance and gender and sexual violence.
- Lack of political and legal power and legal protection.
- Harmful traditional practices such as female genital mutilation/cutting, early and forced marriage, vaginal douching and women inheritance.
- Women living in poverty may adopt behaviors that expose them to HIV infection, including the exchange of sexual favors for food, shelter or money to support themselves and their families.
SOCIETAL FACTORS THAT PUT WOMEN AT RISK
- In Nigeria men often have more than one sexual partner and it is common for older men to have sexual relationship with much younger women. This contributes to:
o Three times higher infection rate among young women (15 – 24 years) compared to young men of the same age.
o One-third (33%) of married women in Nigeria being in polygamous union.
o 16% of girls initiate sexual activity before age 15
o At least 40% of girls are married by age 15.
o Twenty three percent (23%) of young women begin child bearing between 15 – 19 years.
- Women are likely to face barriers in accessing HIV prevention, treatment and care services due to the limited decision making power, lack of control over financial resources, restricted mobility and child- care responsibilities.
- Women and girls are often the primary care-givers in the family, including for those living with and affected by HIV, hindering their economic opportunities.
- Many women lose their homes, inheritance, possessions, livelihoods and even their children when their partners die. This forces many women to adopt survival strategies, including sex work, that increase their chances of contracting and spreading HIV.
- Early marriage is still common nationwide, with young girls often forced into marriage and sexual relations, causing health risks, including exposure to HIV.