The Spatial Distribution of HIV Prevalence Rates in Nigeria

Nigeria has witnessed a gradual decline in the national trend of HIV prevalence from the peak of 5.8% in 2001 to 3.4% in 2012. In spite of the decline nationally, there is a wide variation in the distribution of HIV at the sub-national level. This study therefore aims to explore the spatial distribution of HIV in Nigeria. The study was an ecological study of secondary data of the National HIV prevalence studies conducted between 2008 and 2012. The global Moran’s I and Local Moran’s I (LISA) test were used to measure spatial autocorrelation. A final choropleth map of local Moran’s FDR-adjusted p values was produced and a p value of ≤ 0.05 was regarded as statistically significant. The analysis of the data was carried out in R statistical package version 3.2.3. Twenty seven (73%) states showed decline in HIV while 10 (27%) states showed an increase in the HIV prevalence rate between 2008 and 2012. Global Moran I statistics for the country indicates a significant positive spatial autocorrelation of HIV in 2008 and 2010 however, there was no significant relationship in 2012. The choropleth map identified four hot spot significant clusters of HIV in 2008 which reduced to three states in 2010 and one state in 2012. The study showed a number of significant hot spot clusters for HIV in Nigeria though there was a general significant decline in the national HIV prevalence rate in the country. There is need to further understand the drivers of the epidemic in hot spot areas and target specific localized action to stem the tide of the epidemic focusing the scarce resources in the identified hotspot states.