Understanding the roles of donor funds in HIV interventions in Nigeria: A scoping review

Donor funding has been central to Nigeria’s human immunodeficiency virus (HIV) response for over two decades, supporting large-scale prevention, treatment, and health system strengthening. However, concerns persist regarding sustainability, equity, and dependence on external financing. This scoping review synthesizes evidence on the roles, impacts, and challenges of donor-funded HIV interventions in Nigeria. The review followed the Arksey and O’Malley framework and JBI guidance. Searches were conducted in PubMed, Scopus, Embase, Web of Science, and African Journals Online for studies published between 2015 and 2025. Eligible sources included peer-reviewed articles, policy reports, and program evaluations. Data were extracted and analyzed using descriptive and thematic approaches. Seven studies met the inclusion criteria. Major donors included PEPFAR and the Global Fund, with funding focused on service delivery, technical assistance, and performance-based grants. Donor support increased antiretroviral therapy coverage, HIV testing uptake, and viral load monitoring, particularly in high-burden states such as Rivers, Akwa Ibom, and Cross River. Investments also strengthened laboratory systems, supply chains, and health information systems. However, challenges included program verticalization, workforce distortions, and continued reliance on external funding. Equity gaps persisted for key populations due to stigma, criminalization, and limited targeted funding. With over 70% of HIV financing externally sourced, sustainability remains a concern. Donor funding has improved HIV service coverage but reinforced financial dependence and system fragmentation. Long-term sustainability will require greater domestic financing, service integration, stronger governance, and rights-based approaches for key populations.