Open Access Highly Accessed Open Badges Research article

Socio-cultural factors influencing the prevention of mother-to-child transmission of HIV in Nigeria: a synthesis of the literature

Juliet Iwelunmor1*, Echezona E Ezeanolue2, Collins O Airhihenbuwa3, Michael C Obiefune4, Chinenye O Ezeanolue5 and Gbenga G Ogedegbe6

Author Affiliations

1 Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, 123 Huff Hall, 1206 S. Fourth St, Champaign, IL 61820, USA

2 Department of Pediatrics, University of Nevada School of Medicine, 2040 West Charleston Boulevard, Las Vegas, NV, USA

3 Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802, USA

4 Prevention, Education, Treatment, Training and Research-Global Solutions-PeTR-GS, 7 Link Road, Independence Layout Enugu, Enugu 400001, Enugu State, Nigeria

5 Sunrise Foundation, Plot 358 New GRA, Enugu, Nigeria

6 Center for Healthful Behavior Change, Division of General Internal Medicine, Department of Medicine, New York University School of Medicine, New York, USA

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BMC Public Health 2014, 14:771  doi:10.1186/1471-2458-14-771

Published: 30 July 2014



Currently, Nigeria alone accounts for 30% of the burden of mother-to-child transmission of HIV. This review explores the socio-cultural factors influencing prevention of mother-to-child transmission of HIV (PMTCT) service uptake in Nigeria.


Using the PEN-3 cultural model as a guide, we searched electronic databases and conducted a synthesis of empirical studies conducted from 2001 to 2013 that reported the perceptions people have towards PMTCT, the enablers/resources that influence PMTCT service uptake, and the role of nurturers/family or community in shaping actions and decisions towards PMTCT service uptake.


A total of 42 articles meeting the search criteria were retained in this review. Thirty-six (36) were quantitative cross-sectional surveys; three were mixed methods, while three were qualitative studies. The findings highlight that there are perceptions, ranging from positive to negative that influence PMTCT service uptake in Nigeria. Furthermore, lack of available, accessible, acceptable, and affordable resources negatively influence decisions and actions towards PMTCT. Finally, family contexts matter with decisions and actions towards PMTCT service uptake in Nigeria particularly with disclosure and non-disclosure of sero-positive status, fertility intentions and infant feeding choices.


As ambitious goals are established and unprecedented resources deployed towards the elimination of mother-to-child transmission of HIV globally by 2015, there is clearly a need to develop effective family-oriented, culture-centered community-based PMTCT programs in Nigeria so as to improve the low uptake of PMTCT services.

Socio-cultural factors; PMTCT; PEN-3 cultural model