Presentation (CTI)

OBJECTIVES: This study examined how age-of-consent policies influence adolescents’ access to HIV testing, linkage to care, and treatment services in Nigeria. It assessed the implications for early diagnosis, service uptake, and progress toward national HIV control targets.
METHODS: A cross-sectional analysis was conducted using routine program and facility data from adolescent HIV service delivery sites in Adamawa, Taraba and Anambra between 2023 and 2025. Service indicators included HIV testing uptake, linkage to care, and treatment initiation among adolescents aged 10-19 years. A policy review documented age-of-consent requirements for HIV testing and treatment. Program records and service documentation were reviewed to identify reported barriers to service use. Descriptive analysis compared service utilization between younger adolescents below the legal age of independent consent and older adolescents who could access services without parental approval.
RESULTS: Adolescents below the legal age of independent consent had lower HIV testing uptake and longer delays in linkage to care compared to older adolescents. Program records indicated that fear of parental disclosure and concern about being perceived as sexually active were commonly documented barriers to service use. Some adolescents who were aware of their HIV status postponed treatment initiation due to consent requirements. Lower testing uptake and delayed treatment initiation among younger adolescents were associated with later diagnosis and missed prevention opportunities during a period of early sexual activity.
CONCLUSIONS: Age-of-consent policies restrict timely access to HIV services for adolescents in Nigeria and may hinder progress toward the 95-95-95 targets. Allowing age-appropriate independent access to HIV testing and treatment, alongside appropriate safeguards and counseling support, could reduce delays, improve early care, and strengthen HIV control efforts.