Determinants of human immunodeficiency virus (HIV) infection in Nigeria: A synthesis of the literature

Nigeria has an estimated 3.5 million human immunodeficiency virus (HIV) positive individuals, ranking third worldwide. This study analyzes the determinants of HIV infection to enable improvements in HIV programming in Nigeria and other developing countries. The methodology used is a literature review of grey and electronic databases of reviewed journals, analyzed in terms of an adapted version of Dahlgren and Whitehead’s (1991) determinants of health model. A total of 43 publications (14 reports and 29 articles) were reviewed. Political, work environment, healthcare service, social network, lifestyle, and gender determinants are predominant over others. The level of political commitment to HIV control is extremely low: over 90% of funding is from foreign sources. Stigmatization leads to delayed and inadequate treatment; and economic and social hardships for HIV-positive individuals. New infections are emerging at increasing rates among individuals engaging in sexual relationships such as men having sex with men (MSM) and female sex workers (FSW). HIV control in Nigeria is financially over-dependent on foreign intervention. Political action is required to formulate and implement a human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) policy that provides legal, social, and economic support for people infected and affected by HIV/AIDS. Measures are required to inform about scientific safeguards against infection, and to reduce HIV stigma among the general population and healthcare workers in particular. Most-at-risk populations require education, legal and economic support, and access to effective health care without negative repercussions, in order to minimize new infections.