Experts Raise Alarm Over Surge in Advanced HIV Cases Among Nigerian Children, Adolescents

Health experts have expressed concern over the rising number of children and adolescents diagnosed with Advanced HIV Disease (AHD) in Nigeria, attributing the trend to persistent stigma, low public awareness, and inadequate access to diagnostic services.

The warning follows the release of findings from a recent study conducted by the IMPAACT4HIV Consortium across Lagos, Kano, Rivers, and Gombe states. The research assessed the barriers hindering effective management of HIV among young patients and their caregivers.

Presenting the findings to journalists in Abuja on Friday, Dr. Ramat Garra, Executive Director of Support for Women and Teenage Children, stressed that many AHD cases could be avoided through improved awareness and early treatment.

According to the study, which employed focus group discussions and key informant interviews, a significant number of caregivers and community members lack basic knowledge of Advanced HIV Disease or its symptoms.

“In Rivers State, over 60 per cent of community participants showed little to no understanding of AHD warning signs, while caregivers at HIV clinics in Kano said they had never been informed about the condition,” Dr. Garra disclosed.

She explained that this lack of awareness often results in delayed medical intervention, with caregivers only seeking help when the disease has reached an advanced stage.

Stigma was also identified as a critical factor worsening the health outcomes of young HIV patients. Dr. Garra noted that many adolescents skip medications due to fear of being seen at treatment centres, while some parents delay disclosing their child’s HIV status, allowing the disease to progress unnoticed.

“In Gombe State, three people reportedly died in the past year after stigma pushed them toward herbal remedies instead of seeking medical care,” she added.

The report further revealed significant gaps in diagnostic capacity across health facilities. Essential tools such as CD4 count tests, Cryptococcal Antigen tests, and TB-LAM assays were often unavailable. In Kano, shortages of testing reagents led to diagnostic delays, while some patients with cryptococcal infections in Gombe were discharged without treatment due to a lack of medication.

The consortium noted that none of the four states surveyed have a dedicated policy for managing Advanced HIV Disease, relying instead on general national HIV guidelines. Experts warned that this policy gap has resulted in inconsistent funding and ongoing challenges in managing advanced cases.

Financial constraints also remain a major barrier. Although HIV treatment is officially free, indirect costs such as transportation continue to limit access. In Rivers State, changes in drug pickup schedules reportedly increased transport costs for caregivers, while in Gombe, some case managers had to use personal funds to assist patients.

Speaking on the findings, Aaron Sunday, Executive Director of the African Network of Adolescents and Young Persons Development, called on government agencies, donors, and health providers to take urgent action. He urged state governments to develop targeted policies on Advanced HIV Disease with dedicated budgets and to strengthen adolescent-friendly services.

Sunday also called on the National AIDS and STDs Control Programme and implementing partners to ensure a consistent supply of critical diagnostic tools and to integrate AHD screening into paediatric, tuberculosis, and prevention of mother-to-child transmission services.

The IMPAACT4HIV Consortium, comprising the African Network of Adolescents and Young Persons Development, Initiative for Sustainable Community Development, and Support for Women and Teenage Children, emphasised that addressing stigma, enhancing diagnostic capacity, and expanding community awareness are essential to preventing avoidable deaths among children living with HIV in Nigeria.