Efforts by the Federal Republic of Nigeria and international nongovernmental agencies to
reduce the impact of HIV in Nigeria have not yielded the anticipated results. This study
focused on the association between attitude, religious beliefs, knowledge of HIV, sexual
risk behavior, and HIV epidemiology in rural and urban Nigeria. This quantitative study
used social-cognitive theory and problem theory. The study was based on the Nigerian
Demographic and Health Survey (NDHS) 2013 data including a sample of 33,006
participants. Specific covariates including gender, sexual partners over the past years, age
at first sexual encounter, socioeconomic status, and literacy level were obtained from the
sample. Two hypotheses from each research question were tested to guide the study
methodology. Linear regression results suggested that knowledge, attitude, location, and
religion predicted sexual risk behavior. Muslims showed the least sexual risk behaviors
compared to other religions while more positive attitudes and more knowledge increased
sexual risk behaviours. Location had no significant impact on sexual risk behavior.
Spearman correlation results depicted a relationship between knowledge and sexual risk
behaviors of urban and rural Nigerians separately. More knowledge depicted an increase
in sexual risk behaviors. The study results may be useful to Ministry of Health and
program planners in constructing culturally based HIV interventions. The significant
relationship between knowledge, attitude towards sex, and religious practices may be
incorporated with theoretical knowledge on social-cognitive variables to enhance further
understanding of the way in which individuals may engage in preventive behaviors to
reduce HIV and its effects in Nigeria. Reductions in the spread of HIV/AIDS would lead
to a healthy and more productive society.