HIV-related knowledge in Nigeria: a 2003-2013 trend analysis

BACKGROUND: Given Nigeria's status as the country with the second highest number of people living with HIV globally, and 9% of the total global burden of HIV being attributable to Nigeria alone in 2013, improving our understanding of the nature of the HIV epidemic in Nigeria is crucial. As HIV-related knowledge may be an important contributor to engagement in preventive behaviours, it is of interest to investigate trends in HIV-related knowledge in Nigeria with the purpose of informing future HIV prevention and education efforts. This study therefore aims to investigate trends in HIV-related knowledge in Nigeria between 2003 and 2013. METHODS: Data were derived from the 2003-2013 Nigerian Demographic and Health Surveys, and HIV-related knowledge scores were computed based on answers to HIV-related knowledge questions in the surveys. The significance of the difference between HIV-related knowledge across the time points was determined via the Kruskal-Wallis test, and changes in HIV-related knowledge were displayed graphically, stratified by relevant socio-demographic characteristics. ARIMA models were fit to the 2003 to 2013 trend data. RESULTS: Although there was generally a decrease in HIV-related knowledge across most knowledge domains in 2008, an overall increase was observed between 2003 and 2013. Unfortunately however, this was not the case for knowledge of mother-to-child transmission, which decreased between 2003 and 2013. The disparity in knowledge of HIV risk reduction between states also increased over time. CONCLUSION: These findings suggest that although HIV-related knowledge appears to be increasing overall, future HIV prevention and education programs should focus on specific knowledge domains such as mother-to-child transmission, and on specific states in which HIV-related knowledge remains low.