Improving Access to HIV and Sexual Reproductive Health Services for Key Populations along Nigeria’s Transport Corridors: The STOP Project

Abstract

Background: Despite high HIV prevalence amongst key populations in strategic travel corridors in Nigeria, there is still very low access to HIV and Sexual Reproductive Health (SRH) services. Targeting men-who-have-sex-with-men, females who sell sex, long distance truck drivers and those who live along the country's transport corridors is vital for effective control of the HIV epidemic in Nigeria. Excellence and Friends Management Consult (EFMC) partnered with the Nigerian National Agency for the Control of AIDS (NACA) to improve access to HIV, SRH services educate and test for HIV, and offer referral/treatment to HIV-infected individuals. We report on the need, process and outcome of this project. Methods:The Strategic Travelers Outreach Program (STOP) took place between February and August 2016 in Sagamu/Ogere and Obollo-Afor travel corridors. Through community advocacy and outreach, house-to-house, door-to-door and community/office testing, key populations were provided with targeted HIV, SRH and referral services.Results: Over 50,000 people were contacted with HIV and SRH education/counselling. 19,275 (M: 10,965, 56.9%; F: 8,310, 43.1%) were tested with all receiving their results same day. General positivity rate was 1.3%: female (1.9%). Brothel-based female sex workers had higher positivity rate (3.2%). The study also revealed prostitutes did not use condoms with their husbands or long-term boyfriends and that knowledge of HIV was poor. Conclusion:The results highlight an urgent need to mobilize educational and healthcare resources to mitigate HIV transmission along these corridors. A socio-anthropological approach is required to alter long-held beliefs and change risk-seeking behavior.