Umar Amina A, Murtala Hassan Adam, Abdullahi Aisha Adam, Aminu Amina, Aliyu Muktar H, Aliyu Sani H, Adeyemi Ololade D, Dongarwar Deepa, Torrelles Jordi B, Aliyu Gambo, Salihu Hamisu M
Department of Community Medicine, College of Health Sciences, Bayero University, Kano, Nigeria.
Department of Epidemiology and Population Health, Kano Independent Research Center Trust, Kano, Nigeria.
Int J MCH AIDS. 2025 Jun 5;14:e013. doi: 10.25259/IJMA_31_2025. eCollection 2025.
Human immunodeficiency virus (HIV) is a major public health concern among pregnant women in Nigeria, with seven in every hundred women likely to have an HIV infection. Understanding factors associated with HIV infection among pregnant women is critical to improving prevention strategies, especially in conflict regions. This study investigates demographic, socio-economic, and behavioral determinants of HIV among pregnant women in Nigeria, with conflict exposure included as a key predictor in the analysis.
This study is a cross-sectional design using data from the 2018 Nigeria HIV/Acquired Immunodeficiency Syndrome (AIDS) Indicator and Impact Survey, the largest population-based HIV survey globally, implemented between July and December 2018 across all 36 states and the Federal Capital Territory of Nigeria. We analyzed weighted data from 3,879,192 pregnant women (both HIV-positive and negative), conducting bivariate and multivariate analyses to identify predictors of HIV infection among women aged 15-49 years while adjusting for potential confounders. Adjusted Odds Ratios (AORs) with 95% confidence intervals (CIs) were generated using unconditional logistic regression models to determine significant predictors.
Our analysis revealed that women in conflict zones were younger, less educated, and more likely to be in polygynous marriages and the lowest wealth quintile compared to those in non-conflict zones. In a multivariable analysis, residence in a conflict zone was associated with nearly twofold adjusted odds of HIV positivity (AOR = 1.93; CI: 0.98-3.82; = 0.057). Increasing maternal age (AOR = 1.06; CI: 1.02-1.10; = 0.002) and middle to fourth wealth quintile status (AOR = 4.10 and 3.80, respectively; < 0.05) were significantly associated with a higher likelihood of HIV infection. Recent non-marital sexual activity was also significantly associated with HIV positivity (AOR = 2.96; = 0.037).
The study identifies conflict exposure and socio-economic status as significant predictors of HIV infection among pregnant women in Nigeria. Our analysis reveals important demographic, socio-economic, and behavioral factors associated with HIV prevalence in this population. These findings underscore the need for comprehensive HIV prevention strategies that address the complex interplay of social determinants, particularly in vulnerable populations.
人类免疫缺陷病毒（HIV）是尼日利亚孕妇面临的一个主要公共卫生问题，每百名女性中就有七人可能感染HIV。了解孕妇感染HIV的相关因素对于改进预防策略至关重要，尤其是在冲突地区。本研究调查了尼日利亚孕妇感染HIV的人口统计学、社会经济和行为决定因素，并将冲突暴露作为分析中的一个关键预测因素。
本研究采用横断面设计，使用2018年尼日利亚HIV/获得性免疫缺陷综合征（AIDS）指标与影响调查的数据，这是全球最大的基于人群的HIV调查，于2018年7月至12月在尼日利亚所有36个州和联邦首都地区开展。我们分析了3879192名孕妇（包括HIV阳性和阴性）的加权数据，进行双变量和多变量分析，以确定15 - 49岁女性中HIV感染的预测因素，同时对潜在混杂因素进行调整。使用无条件逻辑回归模型生成调整后的比值比（AORs）及其95%置信区间（CIs），以确定显著的预测因素。
我们的分析显示，与非冲突地区的女性相比，冲突地区的女性更年轻、受教育程度更低，更有可能处于多配偶婚姻中，且处于最低财富五分位数。在多变量分析中，居住在冲突地区与HIV阳性的调整后比值比接近两倍相关（AOR = 1.93；CI：0.98 - 3.82；P = 0.057）。孕产妇年龄增加（AOR = 1.06；CI：1.02 - 1.10；P = 0.002）以及处于中等至第四财富五分位数状态（AOR分别为4.10和3.80；P < 0.05）与HIV感染的可能性更高显著相关。近期的非婚性行为也与HIV阳性显著相关（AOR = 2.96；P = 0.037）。
该研究确定冲突暴露和社会经济地位是尼日利亚孕妇感染HIV的重要预测因素。我们的分析揭示了与该人群HIV流行率相关的重要人口统计学、社会经济和行为因素。这些发现强调了需要制定全面的HIV预防策略，以应对社会决定因素的复杂相互作用，特别是在弱势群体中。
