Rivers State Overtakes Benue as Nigeria’s HIV Capital: A Deep Dive into the Crisis

On April 24, 2025, a startling claim emerged on X via a post by Naija_PR: Rivers State has surpassed Benue State as Nigeria’s HIV capital. Accompanied by a poignant image of a frail patient undergoing a medical examination, the post has sparked widespread reactions, ranging from skepticism to dark humor. But is this claim accurate? What does it reveal about Nigeria’s ongoing battle with HIV/AIDS?

This article delves into the data, examines the broader context of HIV in Nigeria, and explores the societal attitudes reflected in public responses, shedding light on a public health crisis that demands urgent attention.

Unpacking the Claim: Has Rivers State Truly Overtaken Benue?

The Naija_PR post asserts that Rivers State has eclipsed Benue as the state with the highest HIV prevalence in Nigeria. To evaluate this claim, we turn to the most recent data available on HIV prevalence across Nigeria’s 36 states and the Federal Capital Territory (FCT).

Historical Context: Benue as Nigeria’s HIV Epicenter

For years, Benue State in Nigeria’s North Central zone has held the unenviable title of the country’s HIV capital. According to the 2019 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS), Benue had a prevalence rate of 5.3%, making it the second-highest state after Akwa Ibom (5.5%). Rivers State, in the South-South zone, trailed at 3.8%.

A more recent 2022 Bayesian modeling study published in eClinicalMedicine (part of The Lancet) updated these figures, estimating Benue’s prevalence at 5.7% (95% CI: 5.0–6.3) and Rivers at 5.2% (95% CI: 4.6–5.8). While Benue remained ahead, the gap had narrowed to just 0.5%, with overlapping confidence intervals suggesting the difference might not be statistically significant.

The 2025 Claim: A Closer Look

The Naija_PR post, dated April 24, 2025, lacks a cited source, which raises questions about its reliability. However, the 2022 data hints at a trend: Rivers State’s prevalence is rising, and it’s possible that by 2025, it could have surpassed Benue. Several factors might explain such a shift:

• Rising Transmission in Rivers: The South-South zone, where Rivers is located, has the highest regional HIV prevalence in Nigeria at 5.5% (NAIIS, 2019). Port Harcourt, the state’s capital, is a bustling hub with significant commercial activity, including a high prevalence of transactional sex. Limited access to prevention services, such as condoms and pre-exposure prophylaxis (PrEP), may have fueled new infections.
• Improved Surveillance: Rivers State might have ramped up HIV testing and case detection, leading to a higher reported prevalence. The Institute of Human Virology Nigeria (IHV Nigeria) reported providing antiretroviral (ARV) drugs to 576,171 patients across states including Rivers as of March 2023, suggesting robust health interventions that could uncover more cases.
• Benue’s Progress: Benue has been a focal point for HIV interventions, such as the Benue ART Surge, which may have stabilized or slightly reduced its prevalence through widespread antiretroviral therapy (ART) and prevention efforts.

Without a 2024 or 2025 survey—such as an updated NAIIS or a report from the National Agency for the Control of AIDS (NACA)—the claim remains unconfirmed. The 2022 data suggests Benue likely held its position, but the narrowing gap indicates Rivers could be on the cusp of overtaking it. For now, we must treat the claim as plausible but unverified, pending official statistics.

The Broader HIV Landscape in Nigeria

Nigeria bears the fourth-largest HIV burden globally, with an estimated 1.9 million people living with HIV as of 2020, according to a study published in PMC. The national prevalence rate stands at 1.4% among adults aged 15–49 (NAIIS, 2019), but this figure masks stark regional and state-level disparities.

Regional Disparities

HIV prevalence varies widely across Nigeria’s geopolitical zones:

• South-South Zone: 5.5% (highest, includes Rivers and Akwa Ibom)
• North Central Zone: 2.0% (includes Benue)
• South West Zone: 1.1% (lowest)

At the state level, Benue (5.7%), Rivers (5.2%), Akwa Ibom (3.5%), Edo (3.4%), and Taraba (3.0%) rank among the highest, while states like Jigawa report prevalence as low as 0.3% (2022 estimates). Women are disproportionately affected, with a prevalence of 1.9% compared to 0.9% for men, and young women aged 20–24 are more than three times as likely to be living with HIV as their male counterparts (NAIIS, 2019).

Progress in HIV Control

Nigeria has made notable strides toward the UNAIDS 95-95-95 targets (95% of people living with HIV knowing their status, 95% of those diagnosed on ART, and 95% of those on ART achieving viral suppression by 2030). Key efforts include:

• Testing and Treatment: Organizations like IHV Nigeria and AHF Nigeria have scaled up testing and ART. AHF Nigeria has conducted over 2.5 million HIV tests since 2011 and provides free ART to thousands.
• Prevention: Condom distribution and education campaigns are priorities. AHF Nigeria distributed 27 million condoms since 2011, aiming to curb new infections.
• Policy Frameworks: In 2019, President Muhammadu Buhari launched the Revised National HIV and AIDS Strategic Framework 2019–2021, which aimed to improve the national response to the epidemic by focusing on high-burden areas.

Persistent Challenges

Despite progress, Nigeria faces significant hurdles:

• Stigma and Discrimination: A 2020 PMC study found that 25% of ART patients in Nigeria reported experiencing stigma at family, hospital, community, and workplace levels. This stigma deters testing and treatment adherence, perpetuating the epidemic.
• Low Testing Rates: Only 26% of Nigerians have ever been tested for HIV, reflecting low risk perception and limited access to testing services.
• Funding Gaps: Inadequate funding hampers prevention and treatment efforts, particularly for key populations like sex workers and men who have sex with men (MSM), who face heightened risks but limited support.
• Regional Disparities in Access: High-prevalence states like Rivers and Benue often lack sufficient healthcare infrastructure, exacerbating the crisis.

Public Reactions: A Mirror of Societal Attitudes

The replies to Naija_PR’s post reveal a troubling mix of skepticism, denial, and insensitivity, underscoring the cultural and informational barriers to effective HIV management in Nigeria.

• Skepticism and Denial: User @Kckingson wrote, “Why’s it that you only know you’re HIV positive when you do a test? There’s something they’re not telling us. Are you sure HIV is real?” This reflects a dangerous mistrust in medical science, a sentiment that has historical roots in Nigeria. In the 1990s and 2000s, misinformation about HIV’s origins and transmission fueled stigma, as noted in a PMC study on HIV stigma in Nigeria.
• Insensitive Humor: Replies like @AKANO BABATUNDE’s “Congratulations to them ” and @Freshi Tinx’s “Dem too like fuk fuk” trivialize a serious public health crisis. Such attitudes normalize risky behaviors and undermine awareness campaigns.
• Regional Concerns: Users like @Acid (“Make e no reach portharcourt abeg”) and @Kanayochukwu01 (“My own Rivers state”) express localized fears, highlighting the emotional toll of the epidemic on affected communities.

These reactions align with findings from the PMC study, which noted that HIV-related stigma remains a major barrier to testing and treatment. The study highlighted inconsistencies in how stigma is measured across Nigerian studies, but a common thread is clear: negative attitudes toward people living with HIV (PLHIV) persist, often rooted in misinformation and cultural taboos around sex and illness.

The Image: A Symbol of the Crisis

The image accompanying the Naija_PR post depicts a frail, shirtless patient being examined by a doctor using a stethoscope. The doctor’s white coat bears a logo resembling the Red Cross, symbolizing the involvement of humanitarian organizations in Nigeria’s HIV response.

The patient’s emaciated frame likely reflects the physical toll of advanced HIV/AIDS, a stark reminder of the consequences of delayed diagnosis and treatment. This image underscores the human cost of the epidemic, particularly in high-prevalence states like Rivers and Benue, where access to timely care remains a challenge.

Moving Forward: Addressing Nigeria’s HIV Crisis

The potential shift of Nigeria’s HIV epicenter from Benue to Rivers, if true, signals an urgent need for targeted interventions. Here are key steps to address the crisis:

1. Enhanced Surveillance and Data Collection: NACA and UNAIDS should prioritize an updated NAIIS to provide accurate, state-level prevalence data. This will clarify whether Rivers has indeed overtaken Benue and guide resource allocation.
2. Scaling Up Prevention and Testing: High-prevalence states like Rivers need expanded access to condoms, PrEP, and HIV testing. Mobile testing units and community outreach can bridge gaps in awareness and access.
3. Combating Stigma Through Education: Public campaigns must address misinformation and stigma, emphasizing that HIV is a manageable condition with proper treatment. Engaging community leaders and influencers can shift cultural attitudes.
4. Increased Funding: The government and international partners must boost funding for HIV programs, particularly for key populations and high-burden areas. Ensuring consistent ART supply and healthcare infrastructure is critical.
5. Localized Interventions: Rivers State should adopt Benue’s model of targeted ART surges, focusing on urban centers like Port Harcourt to curb transmission.

Conclusion

The claim that Rivers State has overtaken Benue as Nigeria’s HIV capital remains unconfirmed without 2024 or 2025 data, but the 2022 estimates suggest a narrowing gap that warrants concern. Nigeria’s HIV epidemic, with its 1.9 million affected individuals, continues to challenge public health systems, exacerbated by stigma, low testing rates, and regional disparities.

The reactions to Naija_PR’s post reflect a society grappling with misinformation and insensitivity, highlighting the need for education and cultural change. As Nigeria strives toward the UNAIDS 95-95-95 targets, addressing these systemic and societal barriers will be crucial to turning the tide against HIV/AIDS. For now, the image of a frail patient in Rivers State serves as a sobering reminder: behind the statistics are real lives in need of urgent support.