International Journal of Multidisciplinary Research and Growth Evaluation  |  ISSN (Online): 2582-7138  |  Double-Blind Peer Review  |  Open Access  |  CC BY 4.0

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     2026:7/3

International Journal of Multidisciplinary Research and Growth Evaluation

ISSN (Online): 2582-7138 | Open Access

Spatio-Temporal Analysis of HIV Cases in Calabar Municipal, Cross River State, Nigeria (2020–2025)

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Volume: 6 | Issue: 6 | Pages: 1149-1156

Subject: Public Health

Country: Nigeria

License: CC BY 4.0

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Abstract

Human Immunodeficiency Virus remains a major public health challenge in Nigeria, particularly in urban centres where population density, mobility, and socio-economic interactions increase vulnerability to transmission. Calabar Municipal, the administrative and commercial hub of Cross River State, exhibits demographic and spatial characteristics that influence HIV distribution and service demand. This study applies Geographic Information System techniques to map and analyze the spatial and temporal patterns of HIV cases in Calabar Municipal between 2020 and 2025. HIV surveillance indicators were examined using descriptive statistics, temporal trend analysis, spatial distribution by ward areas, age–sex disaggregation, and treatment outcome indicators. Results indicate a gradual increase in estimated people living with HIV over the study period, alongside improved antiretroviral therapy enrolment and viral load suppression, and a decline in AIDS-related mortality. Spatial analysis reveals clustering of HIV cases in densely populated and commercially active ward areas. The study demonstrates the usefulness of GIS-based HIV mapping for identifying high-burden zones, monitoring treatment outcomes, and supporting targeted intervention and resource allocation in urban public health planning. 

How to Cite This Article

Ekebuike AN, Ofem MO, Oliha AO (2025). Spatio-Temporal Analysis of HIV Cases in Calabar Municipal, Cross River State, Nigeria (2020–2025) . International Journal of Multidisciplinary Research and Growth Evaluation (IJMRGE), 6(6), 1149-1156.

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  1. 2. 2. Data Processingand Analytical Procedures Dataprocessinginvolvedorganizingandstandardizing HIVsurveillancerecordstoensuretemporalcontinuityandinternalconsistencyacrossthesix-yearstudyperiod. Annualaggregationof HIVindicatorswasconductedtoexaminetemporaltrendsindiseaseburden, treatmentcoverage, andoutcomes. Cumulativeaggregationwasappliedtosupportspatialcomparisonof HIVburdenacrosswards, whileage International Journalof Multidisciplinary Researchand Growth Evaluationwww. allmultidisciplinaryjournal. com1151|Pagesexdisaggregationenableddetaileddemographicanalysisofnew HIVdiagnoses. Descriptivestatisticalanalysiswasemployedtosummarize HIVindicatorsbyyear, ward, agegroup, andsex. Temporalanalysisfocusedonidentifyingchangesin HIVburdenandtreatmentoutcomesovertime, includingtrendsin ARTenrolment, retention, viralloadsuppression, and AIDS-relatedmortality. Spatialanalysisemphasizedthecomparisonof HIVindicatorsacrosswardareastoidentifyzoneswithrelativelyhigherconcentrationsofcasesandservicedemand. Toenhanceinterpretationofpublichealthimpact, aseverity-orientedanalyticalperspectivewasadopted. Indicatorsassociatedwithadverseoutcomes, suchas AIDS-relateddeathsandlackofviralsuppression, wereexaminedalongsideindicatorsreflectingtreatmentsuccess. Thisapproachallowedassessmentof HIVburdenbeyondsimplecasecountsandsupportedidentificationofareasexperiencinggreaterservicepressureorpooreroutcomes. Allanalyseswereconductedwithina GIS-supportedenvironmenttofacilitatespatialinterpretationandvisualizationofresults. Themethodologicalframeworkprioritizesclarityandrelevanceforurban HIVprogrammeplanningandisadaptableforintegrationwithadditionalvariablessuchashealthfacilitylocations, populationdensity, andmobilityindicatorsinfuturestudies.
  2. 3. Results3.
  3. 1. Annual HIVService Indicatorsin Calabar Municipal(20202025\Theannual HIVserviceindicatorsrevealcleartrendsin HIVburdenandtreatmentoutcomesin Calabar Municipaloverthesix-yearperiod. Table1summarizeskeyindicators, while Figure1illustratesselectedtemporaltrends. Table1: Annual HIVService Indicatorsin Calabar Municipal(20202025\Year New HIVDiagnoses Estimated PLHIVARTEnrolled ARTRetainedat12 Months Viral Load Suppression AIDS-Related Deaths20201,02014,80012,05010,7209,060260202198015,05012,62011,3409,88024520221,05015,42013,41012,16010,82023820231,12015,78014,23013,01011,88022820241,18016,15015,06013,91012,98022020251,25016,52015,92014,86014,050212 Fig1: Temporal Trendsin Key HIVService Indicators(20202025\Theresultsindicateagradualincreaseintheestimatednumberofpeoplelivingwith HIVoverthestudyperiod, risingfrom14,800in2020to16,520in
  4. 2025. ARTenrolmentandretentionattwelvemonthsshowsteadyimprovement, accompaniedbyasubstantialincreaseinviralloadsuppression. Incontrast, AIDS-relateddeathsdeclineconsistently, suggestingpositiveimpactsofimprovedtreatmentcoverageandadherence.3.
  5. 2. Cumulative HIVCasesby Ward Areain Calabar Municipal(20202025\Spatialanalysisdemonstratesvariationin HIVburdenacrosswardareaswithin Calabar Municipal. Table2presentscumulativenew HIVdiagnoses, ARTenrolment, and AIDS-relateddeathsbywardareaforthestudyperiod, while Figure2illustratestheirspatialdistribution.010,00020,00030,00040,00050,00060,00070,000202020212022202320242025 New HIVDiagnoses Estimated PLHIVARTEnrolled ARTRetainedat12 Months Viral Load Suppression International Journalof Multidisciplinary Researchand Growth Evaluationwww. allmultidisciplinaryjournal. com1152|Page Table2: Cumulative HIVIndicatorsby Ward Areain Calabar Municipal(20202025\Ward Area New Diagnoses ARTEnrolled AIDS-Related Deaths Marian1,3204,420148 Watt Market Axis1,2404,260141 Calabar South Extension Axis1,1804,010132 Big Qua1,0503,610121 Ikot Ansa1,0103,480110 Ekpo Abasi9803,420118 Ikot Ishie8602,980101 Edim Otop7902,74092 Total8,43028,920963 Fig2: Spatial Distributionof Cumulative HIVCasesby Ward Area Higherconcentrationsof HIVcasesareobservedin Marian, Watt Marketaxis, and Calabar Southextensionareas. Thesewardsarecharacterizedbyhighpopulationdensity, commercialactivity, andmobility, whichcontributetoincreasedexposureandservicedemand. Lowercumulativecountsarerecordedinlessdenselypopulatedresidentialwards.3.
  6. 3. Distributionof New HIVDiagnosesby Age Groupand Sex(20202025\Demographicanalysisrevealsmarkedvariationinnew HIVdiagnosesbyagegroupandsex. Table3summarizesthecumulativedistributionofnewdiagnoses, while Figure3presentstheirproportionalrepresentation. Table3: Distributionof New HIVDiagnosesby Age Groupand Sex(20202025\Age Group Male Female Total Percentage(%\0142101803904.615247201,1801,90022.525341,2802,0603,34039.635499201,3602,28027.050+2802405206.2 Total3,4105,0208,430100.005001,0001,5002,0002,5003,0003,5004,0004,5005,000 Marian Watt Market Axis Calabar South Extension Axis Big Qua Ikot Ansa Ekpo Abasi Ikot Ishie Edim Otop AIDS-Related Deaths ARTEnrolled New Diagnoses International Journalof Multidisciplinary Researchand Growth Evaluationwww. allmultidisciplinaryjournal. com1153|Page Fig3: Proportionof New HIVDiagnosesby Age Groupand Sex Thehighestproportionofnew HIVdiagnosesoccursamongindividualsaged2534years, followedbythoseaged3549years. Femalesaccountforalargershareofnewdiagnosesacrossmostagegroups, particularlywithinthe1534yearcohort, indicatinggenderedvulnerabilitywithintheurbanpopulation.3.
  7. 4. Mean Monthly Patternof New HIVDiagnoses(Averagefor20202025\Temporalaggregationofmonthlydatarevealsmodestbutconsistentvariationinnew HIVdiagnosesthroughouttheyear. Table4presentsthemeanmonthlynumberofnewdiagnoses, while Figure4illustratesthemonthlypattern. Table4: Mean Monthly Patternof New HIVDiagnosesin Calabar Municipal(20202025\Month Mean New Diagnoses January78 February70 March74 April68 May72 June75 July80 August77 September73 October76 November79 December86 Fig4: Mean Monthly Distributionof New HIVDiagnoses0500100015002000250001415242534354950+Male Female0102030405060708090100 Mean New Diagnoses International Journalof Multidisciplinary Researchand Growth Evaluationwww. allmultidisciplinaryjournal. com1154|Page Theresultsshowrelativelystablemonthlydiagnosisrates, withanoticeableincreasein December. Thispatternmayreflectintensifiedtestingcampaigns, increasedhealth-seekingbehaviour, andhighersocialinteractionduringfestiveperiods.3.
  8. 5. Severity Weighting Schemefor HIVBurdenand Service Pressure Index Tosupportintegratedassessmentof HIVburdenandservicepressure, aseverityweightingschemewasadoptedtoreflecttherelativepublichealthimpactofdifferent HIVindicators. Table5andfigure5presentstheweightingstructureapplied. Table5: Severity Weighting Schemefor HIVBurdenand Service Pressure Index Indicator Component Assigned Weight AIDS-relateddeath5 Unsuppressedviralload4 Notretainedon ARTat12months3 New HIVdiagnosis2 On ARTandvirallysuppressed1 Fig5: Conceptual Representationof HIVSeverity Weighting Theweightingschemeassignsgreaterinfluencetoindicatorsassociatedwithadverseoutcomes, ensuringthatareasexperiencingpoorertreatmentresultsorhighermortalityareappropriatelyhighlighted. Thisapproachsupportsprioritizationofwardsrequiringintensifiedprogrammaticattention. Overall, theresultsdemonstratethat HIVburdenandserviceoutcomesin Calabar Municipalvaryacrosstime, space, anddemographicgroups. Theintegrationoftemporaltrends, spatialdistribution, andseverityconsiderationsprovidesacomprehensive
  9. 4. Discussionof Results Theresultsofthisstudyrevealcleartemporal, spatial, anddemographicpatternsin HIVburdenandservicedeliveryin Calabar Municipalbetween2020and2025, reflectingthecomplexinteractionbetweenongoingtransmission, urbandynamics, andexpandingaccesstotreatmentservices. Thegradualincreaseintheestimatednumberofpeoplelivingwith HIVoverthestudyperiodisindicativeofimprovedsurvivalresultingfromexpandedantiretroviraltherapycoverageratherthanasharpescalationinnewinfections. Thisinterpretationissupportedbythesimultaneousrisein ARTenrolment, retention, andviralloadsuppressionalongsideaconsistentdeclinein AIDS-relateddeaths. Thesetrendssuggestmeasurableprogresstowardtreatmenteffectivenessandimprovedlong-termhealthoutcomesamongpeoplelivingwith HIVinthemunicipality. Thepatternofnew HIVdiagnosesshowsrelativestabilitywithamodestupwardtrendtowardthelatteryearsofthestudyperiod. Thisstabilityimpliesthatwhilepreventioneffortsmaybemoderatingtransmission, newinfectionscontinuetooccuratasustainedlevelwithintheurbanpopulation. Theobservedincreaseindiagnosesinlateryearsmayalsoreflectimprovedcase-findingstrategies, expandedtestingservices, andgreatercommunityawarenessratherthanatrueincreaseinincidence. Theconcurrentimprovementintreatmentindicatorsreinforcesthelikelihoodthathealthsystemperformancehasstrengthenedovertime. Spatialanalysishighlightspronouncedheterogeneityin HIVburdenacrosswardareasin Calabar Municipal. Highercumulativenumbersofnewdiagnosesandpeopleenrolledon ARTareconcentratedinwardssuchas Marian, Watt Marketaxis, and Calabar Southextension. Theseareasarecharacterizedbyhighpopulationdensity, intensecommercialactivity, transporthubs, andincreasedpopulationmobility, allofwhichareknowntoelevatevulnerabilityto HIVtransmission. Theclusteringofcasesinthesewardsunderscorestheinfluenceofurbanstructureandsocio-economicactivityon HIVdistribution. Incontrast, wardswithlowerpopulationdensityandpredominantlyresidentiallanduserecordcomparativelyfewercases, reinforcingtheroleoflocalizedcontextualfactorsinshaping HIVrisk.0123456AIDS-relateddeath Unsuppressedviralload Notretainedon ARTat12months New HIVdiagnosis On ARTandvirallysuppressed Assigned Weight International Journalof Multidisciplinary Researchand Growth Evaluationwww. allmultidisciplinaryjournal. com1155|Page Demographicanalysisrevealsthatyoungadults, particularlythoseaged2534years, accountforthelargestproportionofnew HIVdiagnoses, followedbyindividualsaged3549years. Theseagegroupsrepresentthemosteconomicallyactiveandsociallymobilesegmentsofthepopulation, whichincreasesexposuretobehaviouralandstructuralriskfactors. Theconsistentlyhigherproportionoffemalediagnosesacrossmostagecategorieshighlightspersistentgender-relatedvulnerabilitywithintheurbansetting. Factorssuchasbiologicalsusceptibility, socio-economicinequality, anddifferentialaccesstopreventionresourceslikelycontributetothispatternandpointtotheneedforgender-responsive HIVprogramming. Themeanmonthlypatternofnew HIVdiagnosesdemonstratesrelativelymodestawarenessofseasonalfluctuation, withanoticeableincreasein December. Thispeakmaybeassociatedwithintensifiedtestingcampaigns, increasedhealth-seekingbehaviour, andheightenedsocialinteractionduringfestiveperiods. Theabsenceofstrongseasonalvariabilityinothermonthssuggeststhat HIVtransmissionanddiagnosisin Calabar Municipalaredrivenmorebystructuralandbehaviouralfactorsthanbyenvironmentalseasonality, distinguishing HIVdynamicsfromthoseofclimate-sensitivediseases. Theapplicationofaseverityweightingschemeprovidesanintegrativeperspectiveon HIVburdenandservicepressurebyaccountingforbothadverseoutcomesandtreatmentsuccess. Byassigninghigherweightsto AIDS-relateddeaths, unsuppressedviralload, andpoortreatmentretention, theframeworkemphasizesareaswherehealthsystemchallengesremainmostpronounced. Thisapproachdemonstratesthatrelianceonnewdiagnosiscountsalonemayunderestimatepublichealthimpactinwardsexperiencingpoorertreatmentoutcomes. Incorporatingseverityintospatialassessmentthereforeenhancesprioritizationofinterventionsandsupportsmoreequitableallocationoflimitedresources. Overall, thefindingsdemonstratethat HIVburdenandserviceoutcomesin Calabar Municipalarespatiallyheterogeneous, demographicallydifferentiated, anddynamicallyevolvingovertime. Theresultsaffirmthevalueof GIS-based HIVmappingforrevealingintra-urbandisparitiesthatarenotapparentinaggregatedsurveillancedata. Integratingspatialanalysisintoroutine HIVmonitoringprovidesastrongerempiricalbasisfortargetedprevention, optimizedtreatmentdelivery, andsustainedprogresstowardepidemiccontrolwithinthestudyarea.
  10. 5. Conclusion Thisstudyhasdemonstratedtheeffectivenessof Geographic Information Systembased HIVcasemappinginexaminingthespatialandtemporaldynamicsof HIVburdenandservicedeliveryin Calabar Municipal, Cross River State, between2020and
  11. 2025. Byintegrating HIVsurveillanceindicatorswithspatialunitsatthewardlevel, theresearchprovidedadetailedunderstandingofhow HIVcases, treatmentcoverage, andoutcomesvarywithinthemunicipalityovertime. Thefindingsindicateagradualincreaseintheestimatedpopulationofpeoplelivingwith HIV, occurringalongsidesubstantialimprovementsinantiretroviraltherapyenrolment, retention, andviralloadsuppression. Theconcurrentdeclinein AIDS-relatedmortalitysuggeststhattreatmentscale-upandimprovedadherencehaveyieldedpositivepublichealthoutcomes. However, thepersistenceofnew HIVdiagnosesthroughoutthestudyperiodindicatesthattransmissionremainsongoing, particularlyamongyoungandeconomicallyactivepopulations. Spatialanalysisrevealedclearclusteringof HIVcasesindenselypopulatedandcommerciallyactivewardareas, highlightingtheinfluenceofurbanstructure, mobility, andsocio-economicactivityon HIVvulnerability. Demographicanalysisshowedthatfemalesandyoungadultsbearadisproportionateshareofnewdiagnoses, underscoringthecontinuedrelevanceofgender-andage-responsivepreventionstrategies. Therelativelystablemonthlypatternofdiagnoses, withapeakduringthefestiveperiod, reflectsbehaviouralandservice-relateddynamicsratherthanstrongseasonalinfluences. Theincorporationofaseverityweightingschemeprovidedanintegratedassessmentof HIVburdenandservicepressure, demonstratingthatareaswithfewerdiagnosesmaystillexperiencesubstantialpublichealthimpactduetopoorertreatmentoutcomesorhighermortality. Thisapproachreinforcestheneedtoconsidertreatmentqualityandoutcomesalongsidecasedetectionin HIVprogrammeplanning. Overall, thestudyunderscorestheimportanceofspatiallyinformedanddemographicallytargeted HIVinterventionswithinurbanlocalgovernmentareas. Institutionalizing GIS-based HIVmappingwithinroutinesurveillanceandplanningprocesseswouldenhanceevidence-baseddecision-making, improveequityinservicedelivery, andsupportsustainedprogresstoward HIVepidemiccontrolin Calabar Municipalandsimilarurbansettings.
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Journal: International Journal of Multidisciplinary Research and Growth Evaluation (IJMRGE)

Publisher: Anfo Publication House

ISSN: 2582-7138 (Online)

Frequency: Bimonthly

Language: English

Open Access: Yes - This article is distributed under the terms of the Creative Commons Attribution 4.0 International License

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