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Only 15% of TB cases in 2015 were diagnosed and treated successfully.48 As well as the National Strategic Plan (NSP) on HIV and AIDS 2010-2015, the country initiated a Presidential Comprehensive Response Plan (PCRP) in 2013 as Nigeria was missing national targets in its HIV response.49 As of 2016, whether the PCRP has achieved its stated goal of preventing 105,000 new HIV infections in two years has not yet been reported.However, the PCRP initially led to a significant increase in government spending on its HIV response.50 In early 2015, President Jonathan signed a new antidiscrimination bill into law which secured the rights of people living with HIV, protecting HIV-positive employees from unfair dismissal and from mandatory HIV testing.51 However, in 2016 UNAIDS reported that 21% of people living with HIV had been denied access to health services and reproductive health services due to their status.52 Nigerian cities Abuja and Lagos are among 50 cities with high HIV burdens in the world to be included in the International Association of Providers of AIDS Care’s Fast-Track Cities initiative.In July 2015, it found female sex workers to be using condoms regularly and increasingly aware of HIV risk.More were also testing for HIV although the testing rate remains low at 41.8%.13 There is marked difference between genders with only 17.5% of male sex workers testing for HIV compared to 44.8% of female sex workers.In 2016, prevalence had risen to 23%.17 Men who have sex with men are thought to account for 10% of all new HIV infections in the country.18 In 2014, the Nigerian government increased the punishment for homosexuality to 14 years in jail.Anyone “assisting couples” may face up to 10 years in prison.19 Despite NACA stating that “no provision of this law will deny anybody in Nigeria access to HIV treatment and other medical services”, many Nigerian men who have sex with men do not access HIV services.

Nigeria has the second largest HIV epidemic in the world.1 Although HIV prevalence among adults is remarkably small (2.9%) compared to other sub-Saharan African countries such as South Africa (18.9%) and Zambia (12.4%), the size of Nigeria's population means 3.2 million people were living with HIV in 2016.2 An estimated 60% of new HIV infections in western and central Africa in 2015 occurred in Nigeria An estimated 60% of new HIV infections in western and central Africa in 2015 occurred in Nigeria,3 together with South Africa and Uganda, the country accounts for almost half of all new HIV infections in sub-Saharan Africa every year.

This will enable health centres to reduce costs without reducing services and provide real-time information to patients.54 One of the major barriers to accessing HIV prevention programmes for men who have sex with men are laws that prohibit their activities.

For example, same-sex relations in Nigeria are criminalised with 14 years imprisonment.

33 34 An estimated 1.8 million children have been orphaned by AIDS, which has had a huge impact on their health, safety and wellbeing of these children.35 Around 20% of orphans and vulnerable children do not attend school regularly and around 18% have been sexually abused.36 HIV also has an indirect impact on children in Nigeria whereby they become the caregivers for parents who are living with HIV.

Often, this responsibility lies with girls rather than boys.37 This reflects the imbalance in schooling between the two genders in Nigeria, with girls missing out on HIV education that could teach them how to protect themselves from infection.

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