Nigeria has the second largest HIV epidemic in the world. Although HIV prevalence among adults is much less (1.3%) than other sub-Saharan African countries such as South Africa (19%) and Zambia (11.5%), the size of Nigeria’s population means 1.8 million people were living with HIV in 2019. Recent drops in prevalence estimates for the country has been attributed to better surveillance.
Nevertheless, UNAIDS estimates that around two-thirds of new HIV infections in West and Central Africa in 2019 occur in Nigeria. Together with South Africa and Uganda, the country accounts for around half of all new HIV infections in sub-Saharan Africa every year. This is despite achieving a 13% reduction in new infections between 2010 and 2019.
Unprotected heterosexual sex accounts for 80% of new HIV infections in Nigeria, with the majority of remaining HIV infections occurring in key affected populations such as sex workers.
Six states in Nigeria account for 41% of people living with HIV, including Kaduna, Akwa Ibom, Benue, Lagos, Oyo, and Kano. HIV prevalence is highest in Nigeria’s southern states (known as the South South Zone), and stands at 5.5%. It is lowest in the southeast (the South East Zone) where there is a prevalence of 1.8%. There are higher rates of HIV in rural areas (4%) than in urban ones (3%).
Approximately 45,000 people died from AIDS-related illnesses in Nigeria in 2019. Since 2010, AIDS-related deaths have decreased by 35% to 2019, and 89% of those with a positive diagnosis in Nigeria are accessing antiretroviral treatment (ART).