Understanding the relationship between HIV/AIDS, gender and marital status: Evidence from a national population-based HIV testing in Nigeria

Background: Strategies aimed at reducing the impact of HIV epidemic require an understanding of the relationship between gender, marital status and HIV/AIDS. Gender differences are seen as the root of a number of social, economic and political factors that drive the epidemic. This paper assesses relationship between HIV, gender and marital status

Methodology: In 2007, Federal Ministry of Health Nigeria in collaboration with the Society for Family Health conducted the first population-based biomarker survey called NARHS-Plus. Selection of the eligible respondents (male 15-64years and female 15-49years) was based on a multistage technique. Standard testing algorithm based on World Health Organizations's recommendation was employed. Approval was obtained for ethical appropriateness.

Results: While the national HIV prevalence was estimated at 3.6%, prevalence was considerably higher among women than men (4.0% vs. 3.2%, p<0.0001). Significant association between HIV prevalence and marital status was evident (p<0.0001). In general, prevalence was least among never married (2.5%) respondents; but substantially higher among those that were separated (7.4%), widowed (8.0%) and divorced (8.9%); compared with those that were currently married (4.2%) or living with a sexual partner (2.7%). Again females were disproportionately disadvantaged compared with males (widowed: 2.3% vs. 9.7%, separated: 5.0% vs. 7.4%, & divorced: 3.6% vs. 11.8%).

Conclusion: HIV prevention interventions should target females more. Widowed, divorced and separated are more vulnerable to HIV. This may be due to economic insecurity and socio cultural factors that put women at risk. Interventions focusing on gender rights, female economic empowerment and widows' rights should be encouraged