Abstract
BACKGROUND: Children under the age of 15 represent 3% of the global population living with HIV, 9% of new HIV infections, and 12% of all deaths related to AIDS. This study describes the predictors of HIV among children aged 0-14 years in Nigeria.
METHODS: We analyzed data from a weighted sample of 84 130 443 children aged 0-14 years, collected as part of the 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS), the largest in the world. Descriptive statistics, chi-square tests, and the Kruskal Wallis Test were employed to assess the differences between HIV-positive children in urban versus rural areas. Adjusted odds ratio (AOR) and 95% Confidence Interval (CI) from logistic regression models were used to delineate predictors of pediatric HIV.
RESULTS: Weighted data on a total of over 84 million children was 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 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 associated with increased likelihood of pediatric HIV. Other sociodemographic and contextual factors, including child's age, sex, residence, school enrollment, and conflict zone status were not significantly associated with pediatric HIV acquisition.
CONCLUSIONS: 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 ART and PMTCT programs. These findings emphasize the need for strengthened targeted interventions focusing on maternal care, HIV prevention, and healthcare access among vulnerable populations.