Background: Children and adolescents living with HIV in SSA are concentrated in Kenya, Mozambique, Nigeria, South Africa, Uganda, and the United Republic of Tanzania – accounting for >58% of children and adolescents living with HIV in this region. Reducing the transmission of HIV among adolescents can be achieved through improving HIV knowledge. This study assessed the correlates of HIV knowledge and risk perception of adolescents aged 10-14 years in Nigeria. Methods: Weighted data of 4142 adolescents who reported HIV awareness was obtained from the 2018 Nigeria HIV/AIDS Indicator and Impact Survey. Knowledge was measured using 10 comprehensive questions, and categorized into three: low (0-2), moderate (3-5), and high (6-10). Multivariable multinomial analysis was performed, and statistical significance was set at 5%. Results: Majority of the adolescents had low knowledge (52.2%), and only a few (3.4%) had high HIV knowledge. While some adolescents obtained 0/10 questions (17.3%), the maximum score was 7/10 questions (0.5%). Residence in rural areas (aOR: 0.76, 95%CI: 0.62-0.94), belonging to the rich (aOR: 1.70, 95%CI: 1.04-2.77) and richest wealth class (aOR: 2.04; 95%CI: 1.22-3.42) were significantly correlated with moderate knowledge of HIV. Adolescents who had never discussed HIV with parents had lower odds of moderate (aOR: 0.69; 95%CI: 0.57-0.83) or high (aOR: 0.57; 95%CI: 0.35-0.92) knowledge of HIV. About 8% (339/4142) reported that they were likely to get HIV. Reasons adolescents think they were at risk of contracting HIV included “had sex without a condom” (18.8%), “have had blood transfusions” (8.8%), and “have or had many boy/girlfriends” (6.0%). Conversely, about 90% reported that they were not at risk of contracting HIV, or they don’t know if they were at risk of contracting HIV. Adolescents reported “abstinence” (44.0%), thought of “being a good person” (12.8%), “attendance of church/religious house” (3.8%) as major reasons why they think they are not at risk of contracting HIV. Discussion: Knowledge and risk perception of HIV among young adolescents is underwhelmingly low. Findings highlight the need for targeted interventions to enhance HIV education among adolescents, especially in socioeconomically vulnerable areas. There is a need to devise strategies that can foster open parental discussions on HIV transmission to improve adolescents’ HIV knowledge and prevent risky behaviors.
