Introduction HIV self‐testing (HIVST) offers an alternative to facility‐based HIV testing services, particularly for populations such as men who have sex with men (MSM) who may fear accessing testing due to stigma, discrimination and criminalization. Innovative HIV testing approaches are needed to meet the goal of 90% of people living with HIV being diagnosed. This study piloted an intervention to distribute oral HIVST kits to MSM through key opinion leaders (KOLs) in Lagos, Nigeria and assessed the feasibility, acceptability, uptake of HIVST and linkage to HIV treatment.MethodsA cohort study was conducted (May through September 2017) with 319 participants who were recruited by 12 KOLs through their networks. A baseline survey was conducted at the time of the oral HIVST kit (OraQuick® HIV antibody test) distribution to eligible MSM followed by a 3‐month follow‐up survey to assess usage of and experience with the HIVST kits. Each participant was given two kits.ResultsThe median age of the participants was 25 years, 88.7% were literate and 17.9% were first‐time testers. Of the 257 participants (80.7% retention) who completed the three‐month follow‐up interview, 97.7% reported using the HIVST kit and 14 (5.6%) self‐reported an HIV positive result. A quarter (22.7%) tested themselves the same day they received the kit, and 49.4% tested within one week. Almost all participants reported that the HIVST kit instructions were easy or somewhat easy to understand (99.6%) and perform the test (98.0%). The most common reasons they liked the test were ease of use (87.3%), confidentiality/privacy (82.1%), convenience (74.1%) and absence of needle pricks (64.9%). All 14 participants who tested positive had sought confirmatory testing and initiated HIV treatment by the time of the three‐month survey.ConclusionsHIVST distribution through KOLs was feasible and oral self‐testing was highly acceptable among this urban MSM population. Despite concerns about linkage to treatment when implementing self‐testing, this study showed that linkage to treatment can be achieved with active follow‐up and access to a trusted MSM‐friendly community clinic that offers HIV treatment. HIVST should be considered as an additional option to standard HIV testing models for MSM.
HIV prevalence among MSM in the 3 cities was 4-10 times higher than the general population prevalence and was behaviorally linked. In response to a complex set of risks and disadvantages that put African MSM at a greater risk of HIV infection, future interventions targeting MSM should focus on a comprehensive approach that combines behavioral, biomedical, and structural interventions.
Peer-led HCT delivered by S3 had the highest impact on the total number of M-MARPs reached and in identifying HIV-positive M-MARPs and new testers. Training M-MARPs peers to provide HCT is a high impact approach in delivering HCT to M-MARPs.
Men who have sex with men (MSM) are disproportionately affected by HIV in Nigeria. A key strategy in reducing transmission is to increase HIV testing uptake and linkage to treatment for those who test positive. HIV self-testing (HIVST) is an innovative strategy with the potential to increase uptake of HIV testing among key populations at higher risk for HIV. We conducted 23 in-depth-interviews with MSM and two focus group discussions with key opinion leaders to explore perceptions about the feasibility and acceptability of oral HIVST among MSM in Lagos, Nigeria. HIVST was highly acceptable because it was considered convenient to use, painless, private and addressed concerns about stigma. Concerns cited by participants included comprehensibility of instructions to perform and interpret results correctly, as well as lack of support mechanisms to facilitate post-test follow-up and linkage to care. Provision of adequate pre-test information was considered vital as part of the kit distribution process to ensure seamless use of HIVST kits. One-on-one peer-to-peer distribution strategies and retail outlets that facilitate anonymous pick-up are potential distribution channels identified in this study. Overall, our findings suggest that an HIVST program that incorporates these considerations would improve access to HIV testing among MSM in Nigeria.
Aim: To determine the prevalence of HIV infection and associated risk factors among rural pregnant women in Plateau state, Nigeria. Study Design: The study involved a cross-sectional study of pregnant rural women in antenatal clinics (ANCs) in five (5) rural villages of Mangu Local Government area of Plateau State, North Central Nigeria. Methodology: A total of 248 pregnant women with mean age of 26 years were recruited through a random sampling method during ANCs with pre and post counseling initiated and a structured survey questionnaire used. Venous blood samples were collected using needles and syringes, thereafter transported to a central point at Gindiri, centrifuged and serum sent to Plateau Specialist Hospital virology laboratory for HIV testing. Results: Participants with less than six (6) months planned postpartum sexual abstinence(cultural to abstain from Sexual Intercourse during pregnancy) were 8 times significantly more likely (OR 8.2; 95% CI 1.4, 42.0) to be infected compared with those who observed more than six (6) months planned postpartum abstinence. Also, women from polygamous marriages had a five-fold greater and significantly odds (OR 5.36; 95%CI 1.3, 24.5) of being HIV positive compared to women from monogamous marriages. Furthermore, parous women were 4 times significantly more likely (OR 4.66; 95%CI 1.1, 20.0) to be infected than nulliparous women. Previous exposure to malaria and educational status were not significantly associated with HIV infection. Conclusion: HIV prevalence was 3.2% (95% CI; 1.5-6.5)comparable to Nigerian's current overall prevalence rate and high lights need to eliminate preventable risk factors and relevance of male involvement in HIV prevention especially during pregnancy including ANCs, Care, Treatment and Support. There was higher rate of HIV infection among women who did not abstain from sexual intercourse during pregnancy suggesting multiple partnerships and need for marital faithfulness especially from the men during pregnancy.
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