CHAPTER ONE

INTRODUCTION

1.1       Background of the Study

In 1981, a new syndrome, the acquired immune deficiency syndrome (AIDS), was first recognised in the United States. By 1983, the etiological agent, the human immunodeficiency virus (HIV), has been identified. By the mid-1980’s, it has become clear that the virus had spread, largely unnoticed, throughout most of the world.

Countries of the world can be divided into categories based on infection rate:

Low: Where HIV infection may have existed for years, but it has never spread to significant levels in any sub-population. Recorded infection is largely confined to individuals with higher risk behaviour.

Concentrated: Where HIV has spread rapidly in a defined sub-population, but is not well established in the general population. The epidemic state suggests active networks of risk within the sub-population. And the further course of the epidemic is determined by the frequency and nature of links between highly infected sub-populations and the general population.

Generalised: In generalised epidemic, HIV is firmly established in the general population. Although sub-populations at high risk may continue to contribute disproportionately to the spread of HIV (UNAIDS and WHO, 2003:3).

Nigeria is classified as generalised. As at the end of 2009, about 33.3 million persons were estimated to be infected with HIV globally. Of these, 22.5 million (i.e. 68% of the global total) were in the Sub-Saharan Africa, and about 2.98 million in Nigeria. Thus, Nigeria has the second highest number of people living with HIV in the world after South Africa (UNAIDS, 2010).

The first two cases of HIV and AIDS in Nigeria were identified in 1985 and were reported at an international AIDS conference in 1986. In 1987 the Nigerian health sector established the National AIDS Advisory Committee, which was shortly followed by the establishment of the National Expert Advisory Committee on AIDS (NEACA).

At first the Nigerian government was slow to respond to the increasing rates of HIV transmission and it was only in 1991 that the Federal Ministry of Health made their first attempt to assess Nigeria’s AIDS situation (Kanki and Adeyi, 2006). The results show that about 1.8 percent of the population of Nigeria was infected with HIV. And subsequent surveillance reports (Sofo and Toni, 2003; NACA, 2007) revealed that during the 1990’s HIV prevalence was 3.8% in 1993, 4.5% in 1996, 5.8% in 2001, 5.0% in 2003 and 4.4% in 2005. This trend is shown in figure 1.1 below

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5.4