EPIDIOMOLGY OF HIV IN NIGERIA

byDr Ibrahim M Kida

HIV EPID SUBSAHARAN AFRICA

• Sub-Saharan Africa continues to be the hardest-hit area in the world.

• Only 10% of the world’s population lives in sub-Saharan Africa,

• But 68% of the world’s HIV-infected, 76% of all AIDS deaths in 2007 occurred in that region.

• Of the 33 million individuals infected worldwide, 22.5 million are living in sub-Saharan Africa alone.

• More than one half of the 2.5 million new infections that occurred in 2007 were in sub-Saharan Africa.

Cont.• All countries in Africa have an HIV seroprevalence rate

greater than 5%, with some as high as 25%.• In contrast with the developed world, where HIV-

infected men outnumber infected women, • the majority (61%) of HIV infections in Africa occur in

women—an expression of the often highly unequal socioeconomic statuses of women and men in most of the region.

• Three quarters of all women living with HIV in the world are in sub-Saharan Africa; with a total of 13.2 million, women comprise approximately 61% of infected adults in this region.

Cont.• AIDS continues to be the single largest cause of

mortality in Africa.• The HIV/AIDS epidemic has reversed trends toward

longer life expectancy throughout much of Africa. • For example, until the mid-1980s, life expectancy in

Botswana, South Africa, Swaziland, Namibia, and Zimbabwe was increasing; however, the HIV/AIDS epidemic has had a profound effect in the reduction of life expectancy by approximately 13 years in many of these areas.

• Although somewhat mixed, access to treatment has increased considerably in some sub-Saharan African countries,

Cont.

• the beneficial effects of such increases are starting to be translated into declining numbers of AIDS cases and HIV/AIDS-related deaths.

• Botswana, for example, has one of the highest incidences of HIV infection in the world,

• but a successful nationwide rollout of antiretroviral therapy has led to the beginnings of a decline in AIDS-related mortality.

HIV IN NIGERIA.

• In Nigeria, an estimated 3.6 percent of the population are living with HIV and AIDS.

• Although HIV prevalence is much lower in Nigeria than in other African countries such as South Africa and Zambia,

• the size of Nigeria’s population (around 149 million) meant that by the end of 2009,

• there were almost 3 million people living with

HIV seroprevalence trend in Nigeria (1991-2005)

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CONT.

• Approximately 192,000 people died from AIDS in 2009.

• With AIDS claiming so many lives, Nigeria’s life expectancy has declined significantly.

• In 1991 the average life expectancy was 54 years for women and 53 years for men.

• In 2009 these figures had fallen to 48 for women and 46 for men.

HIV/AIDS in Nigeria

Population, 2008 152,600,000

People living with HIV/AIDS, 2007 2,600,000

Women (aged 15+) with HIV/AIDS, 2007 1,400,000

Children with HIV/AIDS, 2007 220,000

Adult HIV prevalence (%), 2007 3.1

AIDS deaths, 2007 170,000

Source: Population Reference Bureau & UNAIDS

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october 2009

Scope of MTCT

Estimated number of Nigerian infants born with HIV each year

64,900–103,840

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Comprehensive PMTCT package

• Primary prevention among young girls and women of reproductive age

• Prevention of unwanted/unplanned pregnancies among those infected

• Interventions to prevent MTCT among infected women that desire children or are pregnant

• Continuous care and support after delivery

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Primary prevention

• A=Abstinence• B=Be faithful to one uninfected partner• C=Universal access and use of condoms• D=Drugs?

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Prevention of unintended pregnancies

• Family planning education• Access to services• Wide availability of effective options

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Western & Central Europe

13001300[<1000 – 1800][<1000 – 1800]

Middle East & North Africa26 00026 000

[18 000 – 34 000][18 000 – 34 000]

Sub-Saharan Africa1.8 million1.8 million

[1.7 – 2.0 million][1.7 – 2.0 million]

Eastern Europe & Central Asia

12 000 12 000 [9100 – 15 000][9100 – 15 000]

South & South-East Asia140 000140 000

[[110 000 – 180 000110 000 – 180 000]]

Oceania11001100[1200][1200]

North America4400

[2600 – 7300]

Latin America44 00044 000

[37 000 – 58 000][37 000 – 58 000]

East Asia78007800

[5300 – 11 000][5300 – 11 000]Caribbean11 000

[9400 – 12 000]

Children (<15 years) estimated to be living with HIV, 2007

Total: 2.0 million (1.9 – 2.3 million)

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Western & Central Europe

<200<200[<100][<100]

Middle East & North Africa57005700

[3800 – 8000][3800 – 8000]

Sub-Saharan Africa330 000330 000

[300 000 – 360 000][300 000 – 360 000]

Eastern Europe & Central Asia

3200 3200 [2400 – 4300][2400 – 4300]

South & South-East Asia21 00021 000

[14 000 – 29 000][14 000 – 29 000]

Oceania<1000<1000

North America<<500[<200]

Latin America46004600

[4200 – 8300][4200 – 8300]

East Asia20002000

[1200 – 3100][1200 – 3100]Caribbean

1800[1500 – 2100]

Estimated number of children (<15 years) newly infected with HIV, 2007

Total: 370 000 (330 000 – 410 000)

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Percentage of people receiving antiretroviral therapy who are children in Sub-Saharan Africa

Nigeria 3% Côte d’Ivoire 5% Malawi 5% Mozambique 6% Rwanda 7% Namibia 7% Zimbabwe 7%

Kenya 8% South Africa 8% Zambia 8% Central African Republic 9% Uganda 9% United Republic of Tanzania 11%

Median 7%

Source: WHO/UNAIDS (2006). Progress on global access to HIV antiretroviral therapy: a report on ‘3 by 5’ and beyond. Geneva, World Health Organization

Summary Statistics

• 33m globally living with HIV/AIDS• 2.7m new infections in 2007 • 60% are females of reproductive age• Risk of MTCT• 90% of MTCT occur in sub-Saharan Africa• Prevention an important focus for pediatric

HIV

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UNAIDS 2009 report