PLoS ONE (Jan 2022)

Achieving HIV epidemic control through integrated community and facility-based strategies: Lessons learnt from ART-surge implementation in Akwa Ibom, Nigeria.

  • Pius Nwaokoro,
  • Olusola Sanwo,
  • Otoyo Toyo,
  • Uduak Akpan,
  • Esther Nwanja,
  • Iheanyichukwu Elechi,
  • Kufre-Abasi Ukpong,
  • Helen Idiong,
  • Bala Gana,
  • Titilope Badru,
  • Augustine Idemudia,
  • Matthew-David Ogbechie,
  • Philip Imohi,
  • Anthony Achanya,
  • Dorothy Oqua,
  • Kunle Kakanfo,
  • Kolawole Olatunbosun,
  • Augustine Umoh,
  • Patrick Essiet,
  • Ime Usanga,
  • Echezona Ezeanolue,
  • Chika Obiora-Okafo,
  • Ezekiel James,
  • Isa Iyortim,
  • Robert Chiegil,
  • Hadiza Khamofu,
  • Satish Raj Pandey,
  • Moses Bateganya

DOI
https://doi.org/10.1371/journal.pone.0278946
Journal volume & issue
Vol. 17, no. 12
p. e0278946

Abstract

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This study examines the lessons learnt from the implementation of a surge program in Akwa Ibom State, Nigeria as part of the Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS) Project. In this analysis, we included all clients who received HIV counseling and testing services, tested HIV positive, and initiated ART in SIDHAS-supported local government areas (LGAs) from April 2017 to March 2021. We employed descriptive and inferential statistics to analyze our results. A total of 2,018,082 persons were tested for HIV. Out of those tested, 102,165 (5.1%) tested HIV-positive. Comparing the pre-surge and post-surge periods, we observed an increase in HIV testing from 490,450 to 2,018,082 (p≤0.031) and in HIV-positive individuals identified from 21,234 to 102,165 (p≤0.001) respectively. Of those newly identified positives during the surge, 98.26% (100,393/102,165) were linked to antiretroviral therapy compared to 99.24% (21,073/21,234) pre-surge. Retention improved from 83.3% to 92.3% (p<0.001), and viral suppression improved from 73.5% to 96.2% (p<0.001). A combination of community and facility-based interventions implemented during the surge was associated with the rapid increase in case finding, retention, and viral suppression; propelling the State towards HIV epidemic control. HIV programs should consider a combination of community and facility-based interventions in their programming.