Religion and HIV/AIDS in Nigeria
22 December 2006
Claire Mack served as a Research Associate at the Institute for
Global Engagement during the fall 2006 term.
As the HIV/AIDS crisis has spread throughout the world, HIV rates
among Christian populations have remained significantly higher than
among Muslim populations. This trend can be seen through the example of
Nigeria, a state known for conflict between Muslim and Christian
populations. With an HIV positive population of over 3 million, Nigeria
has the second highest burden of HIV infection in sub-Saharan Africa.1
Within Nigeria, the highest prevalence rates are found in Christian
areas of the country, such as Benue where 10% of the population is HIV
positive. All of the states with an HIV prevalence rate above 6% are in
the Christian area of the country.2 The prevalence rates within Muslim
states, on the other hand, generally fall between 2-4%.3
Given the religious conflict in Nigeria, many Muslims and Christians
present different explanations for the variance in HIV rates. Muslims
can argue that Christians are more lax in following the moral code set
forth by their religion and are thus more likely to contract HIV.
Christians, on the other hand, explain these rates by arguing that the
societal enforcement of the Islamic code is more oppressive. While both
arguments are common, neither captures the complexity of the issue.
Religion does play a large role in shaping the HIV/AIDS crisis in
Nigeria, but not because of underlying differences in beliefs and moral
choices between Christians and Muslims.
On a fundamental level, Christians and Muslims in Nigeria have
similar views on the why HIV continues to spread: both groups see
promiscuous behavior as the root cause of the HIV crisis. Promiscuity is
frowned upon heavily because of religious teachings and because of
underlying cultural traditions within Nigerian society. Even before
Christianity and Islam were introduced, Nigerian cultural tradition
emphasized the importance of sexual discretion and believed that sex
should be reserved for marriage.4 Leaders in both the Christian and
Muslim communities discourage their followers from pre-marital and
extra-marital sex, and teach that procreation is the main reason for
With this similar aversion to risky sexual behavior that could lead
to contracting HIV, it would seem that the infection rates among both
groups should be comparable, but they are not. To explain the
discrepancy Christians and Muslims tend to look at how each group puts
their beliefs into practice. Many Christians come to the conclusion that
Islam is more repressive and less forgiving than Christianity. The lower
rates are therefore not a reflection of the merits of the religion, but
rather a result of the inherent oppressive nature of the religion. While
Christians do not believe people should engage in sexual behavior before
marriage, a social stigma is the harshest punishment a person would
receive from society if their extra-marital sex is discovered.
Individuals are held accountable by God for their decisions, so any
punishments for extra-marital sex would come from God rather than from
the community. Muslims, on the other hand, could be punished for their
decisions about sex through the system of shari'a law.
If shari'a law has had an impact on risky sexual behavior, one of the
best places to witness it would be Nigeria. In 1999 the governments of
some of the northern states began to formally adopt a system of shari'a
law. There are currently 13 states that operate under a Nigerian form of
shari'a law, which allows for flogging or stoning as a punishment for
extra-marital sex. Many critics of this form have complained that it is
not an authentic shari'a, grounded in the underlying philosophy of
Islam. In its Nigerian version, shari'a has lost many of the fundamental
elements of the original form, including the importance placed upon
forgiveness and understanding. Instead, in many cases, the new form
eliminated the need for multiple witnesses to extra-marital sex and
imposed harsher punishments than would be used in other forms.5
Ordinarily, one would assume that the threat of flogging or death by
stoning would serve as a deterrent against extra-marital sex. A
widespread complaint about Nigerian shari'a, however, is that the
general public was not informed about its implications.6 Because the
switch was mainly to feed into the power struggle with the Christian
government, Muslim officials did not explain what the new consequences
of extra-marital sex would be. It is also unlikely that the punishments
would deter many people because in practice punishments are often
altered or cancelled in Nigeria's justice system. As of September 2004,
six people had been sentenced to death for sex crimes, but none of the
stonings had been carried out.7 There have been cases of flogging, but
not on a large scale. Because of the problems in the implementation of
shari'a in Nigeria, it is therefore unlikely that it has played a large
role in the difference in HIV rates between Christians and Muslims.
Apart from codified shari'a, however, Islam's moral code does of course
stigmatize sexually irresponsibility, yet the results of a number of
studies show that this moral code does not have a great impact on the
average Muslim. Some Muslims follow the rules their religion sets out
for them, but in other cases the same sexual behavior is observed in
Muslim and non-Muslim communities.8 There is no evidence that there is a
strong link between being Muslim and not participating in risky sex.
Instead of explaining away the difference in HIV rates with a dubious
assumption that Muslims are sexually repressed while Christians are not,
we should examine two other key factors that distinguish these two
religious communities: alcohol and circumcision. Christianity does not
advocate excessive drinking of alcohol, but it is not altogether
forbidden. By contrast, alcohol usage is forbidden within Islam, which
could account for part of the discrepancy in HIV rates because alcohol
consumption makes it dramatically more likely that individuals will
engage in high-risk sexual behavior. In general, Muslims throughout the
world are significantly more likely to adhere to the guidelines set
forth about alcohol consumption.9 Without the influence of alcohol,
Muslims are more likely to select less risky sexual partners and use
protection, thereby decreasing their chance of contracting HIV.
Alcohol has had a large presence in Nigerian society throughout
history, and a substantial percentage of Nigerians today consume either
traditional beverages, like palm wine and ogogoro, or more Westernized
beers and wines.10 When looking at who is actually consuming the
alcohol, however, there is a clear divide among the population. In
keeping with the general trend throughout the world, Muslims are
significantly less likely to consume alcohol than Christians.11 Muslims
are more likely to adhere to this rule than to rules about extra-marital
sex because of the nature of the action. Whereas a person could engage
in extra-marital sex secretly, alcohol is generally consumed in public,
where the habit is visible to the entire community. Since the habit is
forbidden, a Muslim would not want to be associated with alcohol
consumption, and would most likely want to avoid it entirely. Although
drinking is not encouraged among Christians, it is still socially
acceptable in many situations and would not be frowned upon as heavily.
Because of this, Nigerian Christians are more likely to consume alcohol
and impair their judgment than Nigerian Muslims.
Even more significant than alcohol in accounting for the divergent
HIV rates is circumcision. One recent study trying to identify better
ways to prevent the spread of HIV shows that circumcision resulted in a
60% reduction of HIV infection.12 Men who have not been circumcised have
a much greater risk of contracting HIV than do circumcised men. This
statistic is not generally thought to be important in the West, because
circumcision is a relatively common practice. In other parts of the
world, however, it is not. Whether or not a man is circumcised depends
almost entirely on his religion. Circumcision has serious implications
for the spread of HIV in Nigeria because it is very common among
Muslims. Christians are generally not circumcised, but circumcisions
among Muslims are either strongly recommended or mandatory, depending on
how certain Hadith are interpreted.13 In short, because of circumcision
Muslim men are less likely to contract HIV than Christians regardless of
their sexual behavior. As with so many other issues, there have been
many who have tried to turn the spread of HIV/AIDS into a contest
between Christianity and Islam. Ultimately the discrepancies between
rates among Christians and Muslims cannot be explained by the claims
that Christians are more promiscuous and Muslims are more repressed.
There are many Christians who adhere faithfully to a strict moral code,
and there are many Muslims who would ignore the possibility of
punishment by shari'a law to engage in risky sexual behavior. The most
important sources of the HIV difference are actually alcohol usage and
circumcision. Therefore, while religious leaders should still attempt to
use their moral clout to dissuade their followers from risky sexual
behavior, they must first realize that the spread of HIV is a complex
issue, and not simply a black-and-white moral battleground.
1. See http://www.nigeria-aids.org/pdf/2005SentinelSurvey.pdf.
4. Eno Blankson Ikpe, Human Sexuality in Nigeria: A Historical
5. Human Rights Watch, "Political Shari'a?" Human Rights and Islamic
Law in Northern Nigeria Vol. 16, No. 9 (September 2004). 6. Ibid.
8. Peter B. Gray, "HIV and Islam: Is HIV Prevalence Lower among
Muslims?" Social Science & Medicine Vol. 58, No. 9 (May 2004): 346.
10. World Health Organization, Alcohol, Gender, and Drinking
Problems: Perspectives from Low and Middle Income Countries.
11. Ibid. In the WHO study, 36% of those who reported alcohol
consumption in the past year strongly identified themselves as
Christians, whereas only 8% identified themselves as Muslims.
12. Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, and
Puren A, "Randomized, controlled intervention trial of male circumcision
for reduction of HIV infection risk: The ANRS 1265 trial." PLoS Med
2005; 2: 298.
13. See al-Baqarah 2:138, Bihar al-anwar, 12:10.