As of 2014 in "Nigeria, the "HIV prevalence rate among adults ages 15–49 was 3.17 percent. Nigeria has the second-largest number of people living with HIV. The HIV epidemic in Nigeria is complex and varies widely by region. In some states, the epidemic is more concentrated and driven by high-risk behaviors, while other states have more generalized epidemics that are sustained primarily by multiple sexual partnerships in the general population.["citation needed] Youth and young adults in Nigeria are particularly vulnerable to HIV, with young women at higher risk than young men. There are many risk factors that contribute to the spread of HIV, including "prostitution, high-risk practices among "itinerant workers, high prevalence of "sexually transmitted infections (STI), clandestine high-risk heterosexual and homosexual practices, international trafficking of women, and irregular blood screening.
Nigeria is emerging from a "period of military rule that accounted for almost 28 of the 57 years since "independence in 1960. Consequently, the policy environment is not fully democratized. "Civil society was weak during the military era, and its role in advocacy and lobbying remains weak.["citation needed] The size of the population and the nation pose logistical and political challenges particularly due to the political determination of the "Nigerian government to achieve "health care equity across geopolitical zones. The necessity to coordinate programs simultaneously at the federal, state and local levels introduces complexity into planning. The large private sector is largely unregulated and, more importantly, has no formal connection to the public health system where most HIV interventions are delivered.["citation needed] Training and human resource development is severely limited in all sectors and will hamper program implementation at all levels.["citation needed] Care and support is limited because existing staff are overstretched and most have insufficient training in key technical areas to provide complete HIV services.