GistNexus – April 24, 2025.
In a shocking report of the HIV situation in Nigeria, Rivers State took the top spot with the highest population of people living with HIV (PLHIV), overtaking Benue State to second position which had previously held the lead. In the 2024 HIV Spectrum Estimates released by the National Agency for the Control of AIDS (NACA), Rivers now holds a staggering 208,767 cases.
Benue State ranks second with 202,346 reported cases, followed by Akwa Ibom with 161,597 cases. The three states account for over half a million of the over two million Nigerians infected with the disease, which calls for the need to enhance intervention and campaign activities.
A National Picture of HIV Prevalence
The newly published report paints a bleak picture of the HIV pandemic in Nigeria, a country which has made measurable progress in containing the disease over the past decade but still grapples with high prevalence levels in several areas.
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Lagos State, the nation’s commercial center, ranks fourth with 108,649 HIV cases. The high urban population and increased testing rates in the state may be partly to blame for the high figures. Fifth on the list is Anambra State with 100,429 cases, then the Federal Capital Territory, which had 83,333 cases—ranked among the highest in the North-Central region.
Other middle-tier states in the high-prevalence category include Delta with 68,170, Imo with 67,944, Enugu with 61,028, Edo with 60,095, and Taraba with 58,460. The figures confirm the realities that HIV is not a geographically confined issue but a national health concern transcending all geopolitical zones.
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Middle-Tier States and the Rising Curve
A number of states fall into the middle-class prevalence category of moderate but significant HIV burdens. Abia (54,655), Kaduna (54,458), and Kano (53,972) all have troubling infection patterns. Similarly, Plateau State (51,736), Borno (50,433), and Oyo (50,063) remain in the public health limelight.
In the South-South and South-West states, the likes of Cross River (43,452), Ogun (43,348), and Nasarawa (44,993) also maintained high figures and need continued interventions in health and resource deployment.
Adamawa accounted for 40,059 cases, with others like Gombe (31,825), Jigawa (31,409), Osun (30,714), and Niger (29,756). The said states, even though not at the top, still represent a significant share of the national tally.
States With Lower Prevalence
Bauchi State recorded 28,698 HIV cases, with Kogi (28,421), Ondo (27,150), and Katsina (26,788) also being in the lower-middle group. Bayelsa, even though it had a smaller population base, recorded 25,339 cases.
Lowest at the bottom of the list are Yobe (11,956), Zamfara (13,253), Ebonyi (14,151), Sokoto (15,223), Ekiti (18,857), Kebbi (19,339), and Kwara with 20,259. Despite the relatively low numbers, specialists raise a note of caution, leaving room for the possibility of underreporting or limitations in access to testing facilities by rural populations.
Mortality Still High Despite Treatment Advances
The report also recognizes mortality statistics, with an estimated 43,683 people having lost their lives due to HIV-related complications in the past year alone. This includes 28,589 adults—13,650 men and 14,939 women—and 15,094 children aged 0–14. These statistics indicate persistent gaps in timely diagnosis, access to antiretroviral therapy (ART), and effective treatment adherence.
In terms of diagnosis, 1,753,425 of Nigeria’s PLHIV are aware of their HIV status according to the most recent estimates. These include 1,693,457 adults—579,209 men and 1,114,401 women—and 54,983 children.
The country has made notable progress in ART coverage where 1,735,808 individuals are on antiretroviral therapy. These include 1,690,057 adults and 45,751 children. The expansion of access to treatment is encouraging, particularly because ART remains the most effective intervention in preventing disease spread and stopping transmission.
Viral Load Suppression and Successes
Encouragingly, viral suppression rates are on the rise. Of those on treatment, 1,160,256 were viral suppression tested and 1,112,339 had suppressed viral loads. These include 1,083,177 adults—363,531 males and 719,645 females—and 29,162 children.
Viral suppression is a key marker of the success of ART, as individuals with suppressed viral loads are far less likely to transmit the virus. It also enhances quality of life and survival.
Prevention of Mother-to-Child Transmission: A Persistent Gap
The most troubling part of the report is the gap in PMTCT services. An estimated 93,186 pregnant women were found to require ART for preventing transmission from mother to child, but only 31,095 received the treatment.
This gap indicates sustained difficulties in giving pregnant women access to care in formal health facilities. In response to this, NACA Director-General, Dr. Temitope Ilori, expounded that while HIV medication is available, only a few 66% of women visit antenatal care in formal facilities and only 23% deliver in them.
“Women in many cases go to Traditional Birth Attendants (TBAs) or mission houses because of cultural attitudes, logistics, or the fear of stigma. These facilities are not equipped to offer ART, threatening the life of the mother and baby,” Dr. Ilori elaborated.
Stigma, she said, continues to scare many women away from accessing assistance, particularly in rural areas where HIV-related discrimination persists.
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Government’s Response to the Funding Gap
Following fears of potential drug shortages and suspension of foreign aid, the Federal Government has taken steps to close loopholes in funding within the health sector. Dr. Ilori revealed that the Federal Executive Council recently approved $1.07 billion to fund healthcare reforms under the Human Capital Opportunities for Prosperity and Equity programme.
In addition, N4.8 billion has been specifically allocated towards the treatment of HIV, with the Nigerian Senate also allocating N300 billion towards the health sector as a whole in the national budget for 2025.
“These investments are part of a strategic shift that will make the HIV response in Nigeria locally sustainable and not foreign donor-dependent,” Ilori explained.
She went on to add that the focus currently lies on the development of national health systems, the strengthening of service delivery at community levels, and on expanding access to diagnostic capacity and ART, particularly in low-resource environments.
Call for Collective Action
Health experts note that while admirable, meaningful progress also depends on collaborative partnerships among federal and state governments, local nongovernmental organizations, local community leaders, and global partners.
There is also a renewed call for increased awareness, particularly among rural communities where myths and misinformation continue to hinder prevention. Testing, stigma reduction, and adherence to treatment are essential pillars that must be bolstered.
The new NACA report is not a snapshot of HIV in Nigeria today—it is a call to action. With more than two million Nigerians infected with the virus today, an effective, multi-sectoral response is still vital.
Reported by GistNexus Team and Edited by Mr. Chibueze Onwuka