HIV epidemic among key populations in Nigeria: results of the integrated biological and behavioural surveillance survey (IBBSS), 2020–2021

• Published in: Sexually transmitted infections Vol. 101; no. 1; pp. 10 - 16
• Main Authors: Emmanuel, Faran, Ejeckam, Chukwuebuka Chukwukadibia, Green, Kalada, Adesina, Adediran Adesola, Aliyu, Gambo, Ashefor, Gregory, Aguolu, Rose, Isac, Shajy, Blanchard, James
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.02.2025; BMJ Publishing Group LTD
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Condoms - statistics & numerical data; Confidentiality; Cross-Sectional Studies; Data collection; Disease prevention; Epidemics; Epidemiology; Female; Health behavior; Health surveillance; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; Homosexuality, Male - statistics & numerical data; Human immunodeficiency virus; Humans; Laboratories; Male; Medical tests; Middle Aged; Nigeria - epidemiology; Original research; Prevalence; Public health; Risk-Taking; Sample size; Sex Workers - statistics & numerical data; Sexual Behavior - statistics & numerical data; Sexual Partners; Substance Abuse, Intravenous - epidemiology; Supervisors; Surveys and Questionnaires; Teams; Trainers; Transgender persons; Transgender Persons - statistics & numerical data; Young Adult; Nigeria; HIV; AIDS; Transgender
• ISSN: 1368-4973; 1472-3263
• DOI: 10.1136/sextrans-2023-056067

IntroductionNigeria has the fastest-growing HIV epidemic in West and Central Africa and key populations (KPs) bear a higher burden of HIV. This integrated biological and behavioural surveillance survey was conducted among female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID) and transgender (TG) populations to understand the changing dynamics of HIV to improve HIV prevention efforts in Nigeria.MethodsUsing a cross-sectional design, data were collected between October and November 2020 in 12 states, from randomly selected KP members using multistage probability sampling. Behavioural data were collected using a structured questionnaire followed by three rapid HIV tests. The study was approved by ethical review boards in Nigeria and Canada and all ethical considerations including maintaining the privacy and confidentiality of all study subjects were followed.ResultsA total number of 17 975 KP members were interviewed, with a response rate of over 98.0%. A weighted HIV prevalence of 28.8% (95% CI 27.4% to 30.2%), 25.0% (95% CI 23.7% to 26.3%), 15.5% (95% CI 14.3% to 16.4%) and 10.9% (95% CI 9.9% to 11.8%) was found among TGs, MSMs, FSWs and PWIDs respectively. A high number of sex partners and consistent condom use were low for all types of KPs, especially with regular partners. Both MSM and TGs reported high rates of unprotected receptive anal intercourse ranging between 71.2% and 85.0%. Nearly 60.0% of PWID shared their used syringe with another PWID. Overall, 90.2% FSWs, 77.2% MSM, 81.9% TGs and 84.3% PWID were ever tested for HIV.ConclusionThis study highlights the progressing trends of HIV prevalence among all KPs in Nigeria. A focused prevention approach is needed to control the emerging epidemic among KPs who constitute the epicentre of the HIV epidemic in Nigeria.