A prospective cohort study will compare rates of retention-in-care among PMTCT clients who are supported by formally-trained supervised Mentor Mothers versus clients who receive standard-of-care, informal peer support. Study sites are 20 primary health care centers (10 intervention, 10 control) in rural North-Central Nigeria. The study population is HIV-positive mothers and exposed infant pairs (MIPs) (N = 480; 240 MIPs per study arm). Primary outcome measures are the proportion of exposed infants receiving early HIV testing by age 2 months, and the proportion of MIPs retained in care at 6 months postpartum. Secondary outcome measures examine antiretroviral adherence, 12-month postpartum MIP retention, and MTCT rates. This article presents details of the study design, the structured Mentor Mother programs, and how their impact on PMTCT outcomes will be assessed.

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HIV-infected mothers are likely to live in poor housing conditions but their newborns are not at an increased risk of sensorineural hearing loss in this setting barring the potential effect of significantly increased drop-out rate in this group.

Background Mentor mothers provide psychosocial and other support to pregnant and post-partum women living with HIV (WLHIV), which has been shown to enhance maternal-infant outcomes in the prevention of mother-to-child transmission of HIV (PMTCT). Our objective was to assess the acceptability of mentor mothers as a PMTCT intervention, and to explore opinions on mentor mother program composition and delivery among stakeholders in North-Central Nigeria. Methods We conducted nine focus group discussions and 31 in-depth interviews with 118 participants, including WLHIV, pregnant women, male partners, health workers, traditional birth attendants, community leaders, PMTCT program implementers, and policymakers. Participants were purposively recruited from health facilities and surrounding communities in the Federal Capital Territory and Nasarawa State. Transcripts were manually analysed using a Grounded Theory approach, where theory was derived from the data collected. Results Most participants were female (n = 78, 67%), and married (n = 110, 94%). All participant groups found  mentor mothers acceptable as women providing care to pregnant and postpartum women, and as WLHIV supporting other WLHIV. Mentor mothers were uniquely relatable as role models for WLHIV because they were women, living with HIV, and had achieved an HIV-negative status for their HIV-exposed infants. Mentor mothers were recognized as playing major roles in maternal health education, HIV treatment initiation, adherence, and retention, HIV prevention for male partners and infants, and couple HIV disclosure. Most WLHIV preferred to receive mentor mothers’ services at health facilities rather than at home, due to concerns about HIV-related stigma and discrimination through association with mentor mothers. Key mentor mother needs were identified as training, remuneration, and validation as lay health workers. Conclusions Mentor mothers are an acceptable PMTCT intervention among stakeholders in North-Central Nigeria. However, stigma and discrimination for both mentor mothers and their clients remain a critical challenge, and mentor mother needs such as training, pay, and a sustainably supported niche in health systems require focused attention. Trial registration Clinicaltrials.gov registration number (NCT 01936753), registered on September 3, 2013 (retrospectively registered).

Hypertensive conditions during pregnancy increase the risk of stillbirths and place survivors at greater risk of SNHL.

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Background: Key populations are defined groups who, due to specific higher-risk behaviour, are at increased risk of HIV infection irrespective of the epidemic type or local context. Also, they often have legal and social issues related to their behaviour that increase their vulnerability to HIV. In Nigeria, Key population (KP) groups account for a significant portion of new HIV infections. Directly, FSW, MSM and PWID, who constitute an estimated 1% of the adult Nigerian population, contribute nearly 23% of new HIV infections. About 20% of infections may be attributed to female sex workers, their clients and client partners alone, of which three-fourths may be attributable to brothel-based FSWs. People who inject drugs (PWID), MSM and their partners respectively contribute about 9% and 10% of the annual new infections. These KPs and their partners together, who constitute an estimated 3.4% of the adult population, contribute as much as 40% of new infections Methods: This was a retrospective analysis of the programmatic data of an HIV intervention projects among the three key populations in 15 local government areas (LGA) in Lagos, Nigeria, between October 2018 and June 2019. Findings:  Among the MSM, HIV positivity rate was 9.6 %      (2.9% to 15.2%), about 96% were linked and initiated on antiretroviral drugs (ARV). Six months   ART retention rate was 95%. For the FSW, the  HIV infection rate was  of 5% (1.4% -12.9%) and   a linkage and ART initiation  rate was  96.5% while  the  six month ART retention rate was 92% . Among the   male PWID the HIV positivity rate was 1.4%. (0.4%- 17.3%) while the female PWID   HIV positivity rate was 8.14%, which was 8 times the average positivity rate among the male PWID. Linkage and ART initiation rate was 100% among HIV positive PWID but only 50% were still active in care 6months after initiation (ART retention rate).     Conclusions: Having attained   over 90% ARV initiation and retention rates among MSM, FSW and PWID on the project, achieving the 3rd UNAIDS target of 90% viral suppression in the groups is very much possible with appropriate programming. Also engaging social support service such as the use of peers as case managers is associated with excellent   6 month retention outcome.

Background: Nigeria has 10% of the global burden of HIV/AIDS and had HIV prevalence rate of 3.0% in 2014. Adherence to ART is a determinant of viral suppression and risk of transmission, disease progression but suboptimal adherence has been a major challenge associated with a diversity of patient-and programme-related challenges. This study was done to find factors that influence adherence to HAART among HIV/AIDS Patients in Southwest Nigeria.