Predictors of Human Immunodeficiency Virus (HIV) Acquisition among Children 0–14 Years in Nigeria

Abstract

Background and Objective: Children under the age of 15 represent 3% of the global population living with Human Immunodeficiency Virus (HIV), 9% of new HIV infections, and 12% of all deaths related to Acquired Immunodeficiency Syndrome (AIDS). This study describes the predictors of HIV among children aged 0–14 years in Nigeria.

Methods: This cross-sectional study analyzed data from the 2018 Nigeria HIV/AIDS Indicator and Impact Survey, the largest household-based HIV survey globally, using a weighted sample of 84,130,443 children aged 0–14 years collected nationwide from July to December 2018. We employed descriptive statistics, Chi-square tests, and the Kruskal-Wallis test to assess differences in HIV prevalence between urban and rural pediatric populations, while logistic regression models were used to identify predictors of pediatric HIV, with results reported as adjusted odds ratios (AORs) and 95% confidence intervals (CIs).

Results: Weighted data on a total of over 84 million children were analyzed, with a slightly higher median age and school enrollment observed among urban residents. HIV prevalence was low overall, at 0.1% in urban areas and 0.2% in rural areas. Among HIV-positive children, maternal awareness of HIV status was a key determinant: children whose mothers were aware of their HIV-positive status had a significantly lower likelihood of HIV infection (AOR: 0.02; CI: 0.01–0.06; p < 0.001). Conversely, having a living mother (AOR: 6.57; CI: 1.75–24.7; p = 0.005) and younger maternal age were were associated with an increased likelihood of pediatric HIV. Other sociodemographic and contextual factors, including the child’s age, sex, residence, school enrollment, and conflict zone status, were not significantly associated with pediatric HIV acquisition.

Conclusion and Implications for Translation: The findings showed that maternal health significantly influences pediatric HIV outcomes. Children of HIV-positive mothers were less likely to acquire HIV, likely due to antiretroviral therapy and prevention of mother-to-child transmission programs. These findings emphasize the need for strengthened targeted interventions focusing on maternal care, HIV prevention, and healthcare access among vulnerable populations.