• NIMR developing prevention gel to protect women
Nigeria’s fight against HIV faces a critical hurdle as a study by the Nigerian Institute of Medical Research (NIMR) has revealed a 12 per cent prevalence among adolescents and young adults, nearly 10 times the national average of 1.3 per cent.

The study, which screened 883 young people aged 15–24 who had never tested for HIV, recorded 106 positive cases. Researchers noted that this age group lags behind in testing, treatment, and viral suppression, making them a weak link in the national response.

While overall HIV prevalence has declined slightly from 1.4 per cent in 2018 to 1.3 per cent in 2022, progress among adolescents has been slow, threatening Nigeria’s ability to meet the UNAIDS 95-95-95 targets for 2025, considered vital to ending AIDS as a public health threat by 2030.

Director of Research and Coordinator of the Child and Adolescent HIV Programme at NIMR, Dr Agatha David, raised concern that fewer than 25 per cent of adolescents and young adults had ever tested for HIV, with only 23 per cent reporting a test and even fewer tested within the past year. She warned that poor adherence to treatment further undermines progress.

“Many adolescents admitted to not taking their medication regularly despite repeated counselling,” David said, adding that interventions such as directly observed therapy, SMS reminders, and peer navigation have shown promise but are yet to be scaled nationally.

She identified stigma, lack of sexuality education, unplanned pregnancies, and unsafe abortions as major barriers to care. Some studies, she noted, show that 20 per cent of adolescents had sex before age 15, while 15 per cent experienced unplanned pregnancies. Mental health concerns are also significant, with depression, anxiety, and suicidal thoughts reported in more than 20 per cent of HIV-positive adolescents. NIMR is now piloting the integration of mental health counselling into routine HIV care.

Beyond adolescents, women remain disproportionately affected by the epidemic. Dr Sabdat Ekama, a research fellow at NIMR’s Clinical Science Department, disclosed that her team is developing a novel HIV prevention microbicide vaginal gel to close gaps in current prevention options.

The “smart gel,” formulated with two antiretroviral agents, is liquid at room temperature but thickens upon application to prevent leakage. Laboratory studies, she said, have shown promising safety and efficacy results, with animal preclinical trials underway.

“To ensure acceptability, we are engaging high-risk populations to co-create features of the product, making it not only effective but also user-friendly,” Ekama said. “Successful preclinical outcomes will pave the way for human clinical trials.”

Despite the availability of prevention tools such as PrEP, global statistics recorded 1.3 million new HIV infections in 2024. Ekama emphasised that innovative tools remain crucial if the world is to achieve the 2030 Sustainable Development Goal of ending AIDS.