Background The multifaceted impact of economic hardship, insecurity, and flooding on access to antiretroviral therapy
(ART) among people living with HIV/AIDS (PLHIV) in Maiduguri, Nigeria is highlighted by this article. While ART has
transformed HIV from a fatal condition to a manageable chronic illness, achieving consistent access in regions facing
socioeconomic and environmental challenges such as Maiduguri remains a critical issue. Factors such as inflation,
poverty, and high transportation costs hinder PLHIV’s ability to obtain treatment and related medical services. Although
antiretroviral drugs are subsidised in Nigeria, associated costs, including transport-fare and laboratory fees, place a
significant burden on patients. This financial strain disrupts adherence to treatment, risking clinical failures and drug
resistance. Insecurity due to the Boko Haram insurgency exacerbates these challenges.
Methods A comprehensive literature search was conducted using keywords such as ART, economic hardship, Maiduguri,
flooding, and insecurity to identify relevant articles from Scopus, PubMed, and Google Scholar. Boolean operators "AND"
and "OR" were applied to construct precise search strings, ensuring broad yet targeted retrieval of relevant studies. A
total of 27 articles were included based on their relevance, methodological quality, and contribution to the study’s aim.