Rivers Tops Nigeria’s HIV Chart as NACA Reveals Over 2 Million Living with Virus Nationwide

A new report by the National Agency for the Control of AIDS (NACA) has revealed that Rivers State now holds the highest number of people living with HIV (PLWHIV) in Nigeria. The report, titled “2024 HIV Spectrum Estimates,” highlights a growing public health concern across the country, with over two million Nigerians currently infected.

According to the data, Rivers State leads with 208,767 cases, followed closely by Benue with 202,346 and Akwa Ibom with 161,597. Lagos, the commercial capital of Nigeria, ranks fourth with 108,649 recorded cases, while Anambra rounds out the top five with 100,429 cases. The Federal Capital Territory (FCT) also features prominently with 83,333 cases, making it the highest in the North-Central region.

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Regional Breakdown and Prevalence Trends

Other states with significant HIV figures include Delta (68,170), Imo (67,944), Enugu (61,028), Edo (60,095), and Taraba (58,460). The middle-tier prevalence group includes Abia (54,655), Kaduna (54,458), Kano (53,972), Plateau (51,736), and Borno (50,433).

States like Cross River (43,452), Ogun (43,348), Nasarawa (44,993), Adamawa (40,059), and Oyo (50,063) also report substantial numbers. The lower-middle prevalence category includes Gombe (31,825), Jigawa (31,409), Osun (30,714), Niger (29,756), Bauchi (28,698), Kogi (28,421), Ondo (27,150), Katsina (26,788), and Bayelsa (25,339).

Meanwhile, states with the lowest numbers include Kwara (20,259), Kebbi (19,339), Ekiti (18,857), Sokoto (15,223), Ebonyi (14,151), Zamfara (13,253), and Yobe (11,956).

Mortality and Treatment Access: A Mixed Outlook

The report further disclosed that an estimated 43,683 Nigerians died from HIV-related complications in the past year alone. Of these, 28,589 were adults—13,650 males and 14,939 females—while 15,094 were children aged 0–14.

Despite the alarming figures, NACA reported significant progress in testing and treatment. Out of more than two million PLWHIV nationwide, 1,753,425 now know their HIV status, and 1,735,808 are currently receiving Antiretroviral Therapy (ART). This includes 1,690,057 adults (577,632 males and 1,112,425 females) and 45,751 children.

The report also notes that 1,160,256 individuals on treatment were tested for viral suppression, with 1,112,339 confirmed to have suppressed viral loads. These include 1,083,177 adults and 29,162 children, indicating a strong uptake in ART adherence and effectiveness.

Challenges in Prevention of Mother-to-Child Transmission

However, the prevention of mother-to-child transmission (PMTCT) remains a major challenge. Of the 93,186 pregnant women identified as needing ART, only 31,095 received the necessary treatment. This alarming gap suggests significant barriers in maternal health service delivery.

Director-General of NACA, Temitope Ilori, attributed the problem to systemic and societal factors. “While HIV drugs are available at health facilities, only about 66 percent of mothers receive antenatal care in these facilities. Even among those who do, only about 23 percent deliver in health facilities,” she told PREMIUM TIMES.

Ilori added that stigma and fear of discrimination further discourage many women from accessing or continuing treatment, especially when deliveries are carried out at home, mission houses, or by Traditional Birth Attendants (TBAs).

Testing Expansion Leads to Higher Case Detection

Increased case detection is also being linked to expanded testing efforts. Anambra State Commissioner for Health, Afam Obidike, highlighted that intensified testing efforts have contributed to the state’s high case numbers.

“Out of over 100,000 people living with HIV in the state, around 98,000 are currently on treatment,” he explained. “We have increased awareness and access to testing, particularly among pregnant women, and ensured all our facilities are equipped with test kits.”

The commissioner emphasized that identifying more cases should be seen as a positive development in the fight against HIV, as it indicates better testing coverage and improved linkage to care.

Call for Strengthened Response

Despite progress in treatment and viral suppression, the NACA report makes it clear that Nigeria must intensify its efforts, particularly in prevention, stigma reduction, and maternal health outreach. The wide disparity in treatment access among pregnant women and continued regional inequalities underscore the urgent need for improved healthcare delivery systems and public education.

While Rivers, Benue, and Akwa Ibom continue to bear the heaviest burden, nationwide collaboration, donor support, and policy reforms remain essential in the fight to curb HIV in Nigeria.