| Issue/Objective |
In 2024, approximately 1.3 million people acquired HIV globally, with sub-Saharan Africa accounting for nearly half of new acquisitions. Nigeria continues to carry a significant burden, with around 74,000 new acquisitions annually. Much of this progress has been driven by international funding, particularly through PEPFAR-supported prevention programs including PrEP and male condom distribution. However, in 2025, funding disruptions - especially cuts to PEPFAR - have put these gains at serious risk, leading to a 55% decline in male condom distribution and an 85% reduction in PrEP coverage in Nigeria. UNAIDS modelling suggests that without restored prevention efforts, the world could see an additional 3.3 million HIV infections between 2025 and 2030. This study examines how these funding disruptions affect HIV incidence and PrEP coverage in Nigeria through scenario-based modelling. |
| Methodology/Approach |
We used UNAIDS Spectrum and Goals model outputs, incorporating
data from UNAIDS Global AIDS Monitoring 2025, NACA reports, and the World AIDS Day 2025 update. We modelled three scenarios for Nigeria from 2025 to 2030: (1) maintaining 2024 prevention coverage as baseline; (2) continued funding constraints with no restoration; and (3) partial mitigation through domestic funding, including N4.8 billion for ART procurement. New acquisitions were estimated under each scenario and compared to baseline. |
| Results |
Under the baseline scenario, new acquisitions remain around 74,000 per year through 2030. Under continued funding constraints, the model projects a 60% increase, reaching 110,000 new acquisitions annually by 2030. Under partial domestic mitigation, a 30% increase is projected, reaching approximately 90,000 new acquisitions annually. These increases would disproportionately affect key populations including men who have sex with men, female sex workers, and people who inject drugs. |
| Discussion/Conclusion |
Continued funding disruptions risk reversing Nigeria's HIV prevention progress. Domestic efforts alone cannot counter the loss of prevention services. Urgent international support combined with increased domestic financing is critical to rebuilding prevention systems and protecting high-risk populations. Without immediate action, Nigeria faces significant setbacks in meeting the 2030 HIV targets, with consequences extending across sub-Saharan Africa. |
| Presenters and Affiliations |
UWASE NKUSI DIANA Society for Family Health |
