By AWC Health & Development Desk | Abuja

As Nigeria marked World AIDS Day 2025, new national epidemiological data reveal stark disparities in HIV/AIDS prevalence across the 36 states and the FCT, with worrying concentrations among young people aged 15–49, particularly young women aged 15–24, who remain the most vulnerable demographic.

According to the National Agency for the Control of AIDS (NACA) and the 2023–2024 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) updates, the national HIV prevalence stands at 1.3%, but state-by-state figures show sharp variations that now define Nigeria’s HIV landscape.

Where Nigeria Stands — State-by-State HIV Prevalence Estimates

Highest Prevalence States

• Akwa Ibom — 5.6%
• Benue — 4.9%
• Rivers — 3.8%
• Taraba — 2.7%
• Abia — 2.1%

Moderate Prevalence States

• Anambra — 2.0%
• Delta — 1.9%
• Cross River — 1.7%
• Enugu — 1.6%
• FCT Abuja — 1.6%

Lowest Prevalence States

• Katsina — 0.3%
• Jigawa — 0.3%
• Zamfara — 0.4%
• Sokoto — 0.4%
• Yobe — 0.5%

(Data sourced from NACA, NAIIS updates, UNAIDS Nigeria reports and state health ministry surveillance bulletins.)

These figures reveal a clear pattern: the South-South and parts of the North-Central remain Nigeria’s HIV epicenters, while much of the North-West reports significantly lower prevalence.

Why These States Are High-Risk Zones

1. Urbanisation & High-Risk Behaviours

States with major cities — Uyo, Makurdi, Port Harcourt — tend to record higher incidence due to mobility, nightlife economies, and transactional sex.

2. Low Testing Rates in Rural Areas

NACA reports that only about 31% of adults in rural communities test regularly, leaving many undetected cases.

3. Gender Disparities

Women account for 63% of new infections.
Young women aged 15–24 are three times more likely to contract HIV than males in the same age group.

4. Mother-to-Child Transmission (MTCT)

Nigeria still contributes nearly 22% of global MTCT cases, despite improvements in PMTCT services.

5. Stigma & Cultural Barriers

In the North-West and North-East, stigma forces many infected people underground, affecting data accuracy and access to treatment.

Age Groups Most Affected

Nigeria’s HIV burden remains concentrated among:

1. Young Adults (15–49 years)

This age group accounts for over 85% of all HIV cases nationwide.

2. Youths (15–24 years)

• Highest new infection rates
• Driven by early sexual debut, low condom use, gender vulnerability
• Teenage girls are disproportionately at risk due to power imbalances and sexual exploitation

3. Infants (0–5 years)

Majority infected through mother-to-child transmission.

4. Middle-aged adults (50–59 years)

An often-ignored group increasingly showing rising incidence due to lack of targeted sensitisation.

Implications for Nigeria

1. Economic Productivity at Risk

The most affected age group (15–49) is Nigeria’s productive workforce. Rising infection rates could worsen economic losses and deepen poverty cycles.

2. Strain on Healthcare System

ART (antiretroviral therapy) coverage has improved, but with over 1.9 million Nigerians living with HIV, treatment expenditure and supply chains will remain under pressure.

3. Threat to National Development Targets

High prevalence in certain states undermines Nigeria’s journey toward UNAIDS 95-95-95 targets (diagnosis, treatment, viral suppression).

4. Increased Orphanhood & Social Vulnerability

Nigeria currently has over 1.4 million AIDS orphans, according to UNICEF data — a figure that continues to grow.

5. Risk of State-Level Resurgence

Some states with formerly declining numbers now show upticks due to lapses in donor funding and slow domestic financing.

What the Government Must Do Now

1. Scale Up Community Testing & Home-Based Screening

Especially in high-prevalence states with large rural populations.

2. Expand Domestic Funding

Nigeria relies heavily on PEPFAR and the Global Fund; experts warn of funding fatigue.

3. Strengthen Prevention of Mother-to-Child Transmission

Universal HIV testing in ANC (antenatal care) must become compulsory and accessible.

4. Targeted Youth Interventions

• Comprehensive sexuality education
• Free condoms in schools and tertiary institutions
• Youth-friendly reproductive health clinics

5. Roll Out State-Level HIV Emergency Plans

Akwa Ibom, Benue, and Rivers need state-driven HIV response action with:

• mobile testing units
• community awareness campaigns
• free ART access points
• dedicated adolescent HIV programmes

6. Partner with Religious & Traditional Leaders

To reduce stigma, improve acceptance of testing and treatment.

7. Integrate HIV Services into National Health Insurance

To ensure long-term sustainability.

Conclusion: Nigeria Is at a Turning Point

While Nigeria has made commendable progress in reducing HIV prevalence from earlier decades, new empirical data show persistent hotspots, widening gender vulnerabilities, and young people at the center of the crisis.

The message from experts is clear:
Nigeria must not slow down.

With targeted interventions, stronger funding, and political will, the country can achieve the UNAIDS 2030 goals and prevent a resurgence of the epidemic.