T Editing Dictate Styles Voice PLEP coverage is much lower in these groups compared with White MSM, and suppression rates lag in many Southern states (CDC, 2023; HRSA, 2023). In both settings, incomplete uptake of U-U information and PREP contribute to persistent community viral load; Nigeria's disparities are shaped by criminalization and gaps in prevention infrastructure, whereas U.S. disparities track structural racism and state policy. Injection-related exposure is a second driver. In Nigeria, HIV prevalence among people who inject drugs (PWID) is multiple times that of the general population, reflecting scarce sterile-syringe access and fear of arrest that deters service use. Hidden networks enable outbreaks before detection (UNAIDS, 2023). In the United States, opioid- and stimulant-related injection sustains transmission where syringe-service programs and medications for opioid use disorder are restricted; counties without authorized services have documented clusters of rapid spread (CDC, 2023). Compared with Nigeria, the U.S. has broader resources but stark state-by-state legal variation; Nigeria's central challenge is scaling legally enabled harm reduction. A third route is perinatal transmission. In Nigeria, missed antenatal HIV testing. stockouts, and distance to clinics limit PMTCT coverage, keeping preventable infant infections above national targets; Nigeria contributes a large share of the global unmet PMTCT need (PEPFAR Nigeria, 2023; UNAIDS, 2023). In the United States, routine prenatal screening and immediate ART have driven perinatal transmission to very low levels, but gaps persist in areas with limited prenatal care access and among uninsured or unstable housed pregnant people. Thus, while both countries face similar biological pathways, Nigeria's risk is magnified by supply-chain and access barriers, and the U.S. risk clusters where prenatal care and adherence are disrupted. Consequences of HIV/AIDS in Nigeria and the USA Effects of the health issue (Distinguished) Clinically, unsuppressed viral load raises morbidity and mortality in both countries, but co-morbidities differ. In Nigeria, tuberculosis co- Focus