Vulnerability to HIV infection among adolescent girls and young women in Nigeria

Adolescent girls and young women (AGYW) account for a disproportionate number of new HIV infections among young people living with HIV. This study identified factors associated with the vulnerability of AGYW to HIV infection in Nigeria. We conducted a cross-sectional survey of AGYW aged 15–24 years in three states (Akwa-Ibom, Kaduna, and Oyo) and the Federal Capital Territory (FCT) Abuja in Nigeria. We collected information on sociodemographic characteristics, risky sexual behaviors, practices, attitudes, perceptions of HIV, and related socio-cultural experiences from 4320 respondents. We identified twelve vulnerability factors and used a modified Delphi technique to assign relative weights to each. Composite vulnerability score was calculated by adding the weighted scores on all factors for each respondent and dichotomized using k-median analysis. Higher scores corresponded to higher vulnerability to acquiring HIV. More than 43% had a high vulnerability to HIV infection. Being older, of lower educational status, married, in a lower wealth quintile, and having low self-esteem were statistically significantly associated with being more vulnerable to acquiring HIV. Being knowledgeable about HIV prevention was protective but not statistically significant. We conclude that sociodemographic characteristics and self-esteem are important determinants of vulnerability to acquiring HIV among young women in Nigeria. Interventions targeted to reduce vulnerability to HIV among young women must address social-demographic and psychological risk factors.