Although Nigeria’s HIV prevalence appears to have stabilised in the past 10 years, the epidemic still remains a major public health challenge. While Nigeria’s epidemic can be framed as a generalised epidemic, there are concentrated epidemics among high-risk groups or most-at-risk populations (MARPS), i.e. female sex workers (FSWs), men who have sex with men (MSM) and injecting drug users (IDUs). There are also considerable variations according to geographical area, rural/urban locality, age, gender, education and wealth quintile.

Drawing on secondary literature and primary data collection in four selected state-level sites (Adamawa, Benue, Edo and Lagos), including key informant interviews and focus group discussions at national and state levels, this report explores:

• the main drivers of HIV-related vulnerabilities;
• the impacts of HIV on different groups of people and related coping strategies/mechanisms;
• policy and programming responses to HIV;
• and social protection-type responses and approaches and their current and potential linkages with HIV.

The report argues it is clear that further evidence is needed on both the impacts of nascent social protection approaches in Nigeria as well as how best to do social protection in Nigeria in a context of HIV and AIDS. Such a context is one of wide variations, differences and contradictions. Not only do responses need to be tailored to the specific states, but also, to tackle the root causes of vulnerability and poverty, responses need to go below the state level and into communities to understand the key drivers.

What is certain is that there is a need for a more coordinated and equity-based response to social protection, particularly in the context of HIV and AIDS from the national to the local level, among all relevant national and international stakeholders. This will require an increase in political commitment at all levels of government, sustainable and efficient use of donor funding and an increase and improvement in the effectiveness and efficiency of Nigeria’s public expenditure on HIV and AIDS and social protection strategies.