Health experts have raised concerns over the growing cases of Advanced HIV Disease (AHD) among children and adolescents in Nigeria, warning that stigma, poor awareness, and limited access to diagnostic tools are worsening the situation.
The warning follows findings released by the IMPAACT4HIV Consortium, which conducted research in Lagos State, Kano State, Rivers State, and Gombe State to examine challenges faced by children living with HIV/AIDS and their caregivers.
Presenting the findings in Abuja on Friday, Executive Director of Support for Women and Teenage Children, Ramat Garra, said many cases of advanced HIV disease could be prevented through better awareness and early access to treatment.
She explained that the study, which used focus group discussions and key informant interviews, showed that many caregivers and community members had little or no understanding of AHD or its warning signs.
“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,” Garra said.
According to Garra, lack of awareness often leads caregivers to seek medical help only after the illness has reached a critical stage.
She identified stigma as another major factor affecting children and adolescents living with HIV. Many adolescents reportedly stop taking their medications due to fear of being seen at clinics, while some parents delay disclosing their children’s HIV status, allowing the disease to progress.
“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 also highlighted significant gaps in diagnostic capacity in many health facilities, including the unavailability of key tests such as:
- CD4 count tests
- Cryptococcal Antigen tests
- TB-LAM assays
These tests are crucial for detecting advanced HIV disease and related infections.
According to the findings, shortages of testing reagents in Kano delayed diagnoses, 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 studied has a standalone policy addressing advanced HIV disease, as they rely mainly on general national HIV guidelines.
Experts warned that the absence of a dedicated policy framework has led to inadequate funding and gaps in managing advanced HIV cases.
They also highlighted the financial challenges faced by families. Although HIV treatment is officially free, indirect costs such as transportation still limit access to care.
For instance, in Rivers State, changes in drug pickup schedules increased transportation costs for caregivers, while in Gombe some case managers reportedly used personal funds to help patients access treatment.
Also speaking, Executive Director of the African Network of Adolescents and Young Persons Development, Aaron Sunday, called on governments, donors, and healthcare providers to intensify efforts to address the problem.
He urged state governments to develop dedicated policies on advanced HIV disease with specific budget allocations and strengthen adolescent-friendly HIV services.
Sunday also called on the National AIDS and STDs Control Programme and other partners to ensure a steady supply of diagnostic tools and integrate AHD screening into paediatric, tuberculosis, and prevention of mother-to-child transmission services.
The IMPAACT4HIV Consortium, which includes the African Network of Adolescents and Young Persons Development, Initiative for Sustainable Community Development, and Support for Women and Teenage Children, said tackling stigma, improving diagnostic capacity, and increasing community awareness will be critical to preventing avoidable deaths among children living with HIV in Nigeria.
