Structural Violence, Poverty, and TB/HIV in Cross River State, South-South Nigeria: A Social Science Perspective on Health Inequities
1
KNCV Nigeria, Abuja, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Tuberculosis (TB) and HIV/AIDS remain significant public health challenges in Nigeria, with a disproportionate impact on impoverished and marginalized communities. Cross River State, located in South-South Nigeria, experiences a high burden of TB/HIV co-infection, worsened by structural violence, poverty, and systemic healthcare inequities. Structural violence—manifested through inadequate healthcare infrastructure, socioeconomic deprivation, and policy failures—creates barriers to diagnosis and treatment thereby increasing TB and HIV-related morbidity and mortality.
OBJECTIVE:
This study examines the intersection of structural violence, poverty, and TB/HIV co-infection in Cross River State, highlighting the socio-economic and systemic barriers to effective disease management.
METHODS:
A mixed-methods approach was used, combining quantitative analysis of TB/HIV prevalence data (2019-2024) with qualitative interviews of 150 patients and 30 healthcare workers across Cross River south and Northern communities. Socioeconomic indicators such as income level, healthcare access, and treatment adherence were assessed alongside health system challenges.
RESULTS:
TB/HIV co-infection rate in Cross River State was found to be 32.5% among TB patients, significantly higher in impoverished rural areas (40.7%) compared to urban centers (25.3%). Key barriers to care included financial constraints (62%), transportation difficulties (47%), stigma (55%), and healthcare worker shortages (39%). Patients in low-income brackets had a 3.2 times higher likelihood (p < 0.01) of experiencing treatment delays compared to those with better financial stability. Additionally, 73% of surveyed healthcare workers reported inadequate resources and poor healthcare infrastructure as major obstacles to TB/HIV management.
CONCLUSIONS:
Structural violence and poverty significantly contribute to TB/HIV disparities in Cross River State, South-South Nigeria. Addressing these health inequities requires targeted policies, increased healthcare funding, expanded social protection programs, and community-based interventions to improve access to diagnosis, treatment, and care. Strengthening TB/HIV response strategies in impoverished communities is crucial to achieving equitable healthcare and reducing disease burden.
Tuberculosis (TB) and HIV/AIDS remain significant public health challenges in Nigeria, with a disproportionate impact on impoverished and marginalized communities. Cross River State, located in South-South Nigeria, experiences a high burden of TB/HIV co-infection, worsened by structural violence, poverty, and systemic healthcare inequities. Structural violence—manifested through inadequate healthcare infrastructure, socioeconomic deprivation, and policy failures—creates barriers to diagnosis and treatment thereby increasing TB and HIV-related morbidity and mortality.
OBJECTIVE:
This study examines the intersection of structural violence, poverty, and TB/HIV co-infection in Cross River State, highlighting the socio-economic and systemic barriers to effective disease management.
METHODS:
A mixed-methods approach was used, combining quantitative analysis of TB/HIV prevalence data (2019-2024) with qualitative interviews of 150 patients and 30 healthcare workers across Cross River south and Northern communities. Socioeconomic indicators such as income level, healthcare access, and treatment adherence were assessed alongside health system challenges.
RESULTS:
TB/HIV co-infection rate in Cross River State was found to be 32.5% among TB patients, significantly higher in impoverished rural areas (40.7%) compared to urban centers (25.3%). Key barriers to care included financial constraints (62%), transportation difficulties (47%), stigma (55%), and healthcare worker shortages (39%). Patients in low-income brackets had a 3.2 times higher likelihood (p < 0.01) of experiencing treatment delays compared to those with better financial stability. Additionally, 73% of surveyed healthcare workers reported inadequate resources and poor healthcare infrastructure as major obstacles to TB/HIV management.
CONCLUSIONS:
Structural violence and poverty significantly contribute to TB/HIV disparities in Cross River State, South-South Nigeria. Addressing these health inequities requires targeted policies, increased healthcare funding, expanded social protection programs, and community-based interventions to improve access to diagnosis, treatment, and care. Strengthening TB/HIV response strategies in impoverished communities is crucial to achieving equitable healthcare and reducing disease burden.
| eISSN: | 2654-1459 |
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