NACA releases new modes of HIV transmission in Nigeria

The National Agency for the Control of Aids (NACA), says a new research “Estimating Modes of HIV Transmission in Nigeria”, has identified never married adults and key population as increasing HIV rates in Nigeria.

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The Director General of the agency, Dr. Gambo Aliyu, disclosed the statistics in Abuja.

He said that the research gives estimates of where new HIV infections are occurring and can aid prevention planning and focus efforts where they will be most effective.

“The largest number of new infections in the adult  population is estimated to occur among Never Married Females and Never Married Males. The next largest number of new infections occurs among Female Sex Workers and Men who have Sex with Men. These four population groups account for about 91% of all new infections among adults. Key populations (FSW, MSM, PWID) are estimated to account for about 11% of new infections although they represent less than 2% of the  total population. New child infections due to mother-to-child transmission represent the second largest source  new infection accounting for 22% of all new infections. In many states new child infections account for an even larger proportion, up to 50%,” Dr Aliyu said.

He said that the distribution of new infections varies by state.

“However, a large proportion of new infections generally  occur among never married individuals or in Sero-concordant negative couples. Overall, young people and Female Sex Workers appear to be playing an important role in the dynamics of the incidence.

“A study of  formation and dissolution of partnerships among these groups may help understanding this dynamic. Mother to-child transmission represents a large source of new infections nationally and is the largest source in several states. Most of those women who do attend ANC get tested for HIV but over 60% of pregnant women do not attend ANC. Increasing ANC attendance would have benefits not only for reducing HIV transmission,” He said.

According to Dr. Aliyu, the National Agency for the Control of AIDS (NACA), in collaboration with development partners, has been working tirelessly in coming up with strategies to halt the spread of the HIV virus and sustain the epidemic.

“To this end, the Mode of Transmission Study (MOT), which focuses on identifying the sources of new HIV infections in the country and was first conducted in 2009, was recently repeated using an updated model known as the Incidence Pattern Model. This was done to support efforts geared towards preventing new HIV infections using information that was accurate and clearly show where new infections are occurring and among which population group“. He noted.

The Director General also said that it was noteworthy to state that data from the 2018 Nigeria AIDS Indicator Impact Survey (NAIIS) supplied most of the information on population size and characteristics used for the study. The Key population (KP) size, prevalence rate for Key Populations and the number of new infections by State spread were estimated from the recent KP study.

Findings

The study found that the largest number of new infections in the adult population is occurring among Never Married Females and Never Married Males (i.e. Young people). The next largest number of new infections occur among Female Sex Workers and Men who have Sex with Men. These four population groups account for about 91% of all new infections among adults. 

Key populations which represent less than 2% of the total population account for about 11% of new infections. Child infections due to mother-to-child transmission represent the second- largest source of new infection accounting for 22% of all new infections. In many states, child infections account for an even larger proportion, up to 50%.

He noted that though Nigeria is working hard to close these gaps, the findings of the study will further help NACA and partners redirect resources for maximum yields as they look forward to attaining epidemic control with more targeted interventions.

Policy implications

“The policy implications is that efforts will be made to target the following population groups:

• The never married population which is the largest source of new infections and are mostly between the ages of 17 to 34 for females and 19-31 for men. Special efforts are needed to be made to reach this population in schools, workplaces, gathering spots and through social media.

• The new infections through newborns due to low coverage of PMTCT. Efforts will be targeted at encouraging women to attend ANC especially in high prevalence states.

• Increased efforts especially for the highest risk FSW and MSM which has shown that even though the population is small, prevalence remains high among sex workers and MSM in spite of high levels of reported condom use.

The survey also announced a decrease of HIV prevalence amongst married couples in Nigeria while noting that Mother to Child Transmission stands at 22%.