Background: The burden of HIV infection among men who have sex with men (MSM) has posed a huge public health threat to the developing country like Nigeria. Identification of effective strategies to improve their retention in HIV care especially for young HIV infected MSM is critical for overall success in scaling down the national burden of HIV/AIDS. The aim of this study was to assess the facilitators and barriers to retention in HIV care among HIV infected MSM attending community health center, Yaba Lagos Nigeria. Methods: A two months (May –June,2016) exploratory qualitative research study was conducted among 181 respondents enrolled into HIV care within 12 months that attend community health center, Yaba Lagos Nigeria. A pretested and semi-structured questionnaire was used to collect information on the specific facilitators and barriers to retention in HIV care among respondents. Data entries and analysis were done using SPSS package version 20. Descriptive statistics was used to summarize quantitative variables, and frequency tables were generated for the relevant variables. Results: The median age (in years) of the participants sampled was 24. The study identified friendly clinic service 44%, having positive relationship with clinic staff 16%, friendly and secured environment 20% as the major facilitators to retention in HIV care while implicating distance 36% and self -denial 21% as major barriers to retention in HIV care among the respondents. Conclusion: Majority of the respondents were retained in HIV care services due to the available friendly clinic services and conducive environment instituted at the service provision site.

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Background: In sub-Saharan Africa where genotypic drug resistance testing is rarely performed and poor adherence is blamed for the inability to achieve viral suppression and treatment failure, programmatic approaches to preventing & handling these are thus essential. Hypothesis tested was antiretroviral therapy adherence effect on viral load outcome. This study was aimed at determining and monitoring HIV/AIDS disease progression using viral load to provide prognostic information and evaluate patients for viral suppression using the World Health Organization (WHO) guideline strategies. Methods: This study was an observational study of subjects living with HIV already initiated on antiretroviral therapy for at least six months, enrolled in health facilities across Ondo State, South-Western Nigeria, during a 12-month observation period starting October 2018 till September 2019. Quantitative viral load analysis was done using Polymerase Chain Reaction, Roche Cobas Taqman 96 Analyzer. All data were statistically analyzed, using Statistical Package for the Social Sciences (SPSS), with multiple comparisons done using Post Hoc Bonferonni test. Results: A total of 8124 (1947 males & 6177 females) subjects eligible for the study were recruited. Most of them are in the age range of 35 – 39 years, with a mean age of 42.02 ± 10.88 years. 7162 (88.2%) & 1771 (21.8%) of the subjects had viral suppression of <1000 RNA copies per ml and <20 RNA copies per ml respectively. The unsuppressed subjects went through enhanced adherence counselling (EAC) for three months and viral load test repeated thereafter. 192 patients who had completed the three sessions of EAC and repeated viral load increased the entire suppression numbers to 7339 (90.3%) & 1824 (22.5%) <1000 RNA copies per ml and <20 RNA copies per ml respectively during the period of observation. ART adherence has significant effect on viral load outcome from the study hypothesis tested. Conclusion: Current ART regimen & HIV treatment enhanced adherence counseling are key to the achieving viral suppression, thus, routine viral load monitoring will ultimately help in HIV/AIDS disease progression follow up and reduce treatment failure tendencies. This will help more patients stay on first line regimen and prolong their life expectancy, indicating that the UNAIDS last 90 target is achievable.

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