TY - JOUR
T1 - Ensuring optimal community hiv testing services in nigeria using an enhanced community case-finding package (Eccp), october 2019–march 2020
T2 - Acceleration to hiv epidemic control
AU - CDC Nigeria ART Surge Team
AU - Jahun, Ibrahim
AU - Dirlikov, Emilio
AU - Odafe, Solomon
AU - Yakubu, Aminu
AU - Boyd, Andrew T.
AU - Bachanas, Pamela
AU - Nzelu, Charles
AU - Aliyu, Gambo
AU - Ellerbrock, Tedd
AU - Swaminathan, Mahesh
N1 - Funding Information:
This research has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) under the terms of CDC Cooperative Agreement No. CDC-RFAGH17 -1753.
Funding Information:
This was a cross-sectional descriptive study involving PLHIV identified through routine PEPFAR implemented HIV program in Nigeria from October 2019 to March 2020 in nine targeted states. The study was supported by two approved protocols. For results such as small area estimation pertaining to the Nigeria AIDS Indicator and Impact Survey (NAIIS), informed consent was obtained, and the protocol was approved by CDC IRB, University of Maryland Baltimore IRB, and Nigeria Health Research Ethics Committee. For procedures and results pertaining to routine PEPFAR program, de-identified data with no perceived ethical risk to participants were collected, so no informed consent was obtained. PEPFAR routine program implementation and ART Surge were reviewed in accordance with CDC human research protection procedures and were determined to be non-research, public health program activity and received concurrence from the Government of Nigeria Federal Ministry of Health. The study fully complies with the Declaration of Helsinki.
Publisher Copyright:
© 2021 Jahun et al.
PY - 2021
Y1 - 2021
N2 - Purpose: The 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) showed Nigeria’s progress toward the UNAIDS 90-90-90 targets: 47% of HIV-positive individuals knew their status; of these, 96% were receiving antiretroviral therapy (ART); and of these, 81% were virally suppressed. To improve identification of HIV-positive individuals, Nigeria developed an Enhanced Community Case-Finding Package (ECCP). We describe ECCP implementation in nine states and assess its effect. Methods: ECCP included four core strategies (small area estimation [SAE] of people living with HIV [PLHIV], map of HIV-positive patients by residence, HIV risk-screening tool [HRST], and index testing [IT]) and four supportive strategies (alternative healthcare outlets, performance-based incentives for field testers, Project Extension for Community Healthcare Outcomes, and interactive dashboards). ECCP was deployed in nine of 10 states prioritized for ART scale-up. Weekly program data (October 2019–March 2020) were tracked and analyzed. Results: Of the total 774 LGAs in Nigeria, using SAE, 103 (13.3%) high-burden LGAs were identified, in which 2605 (28.0%) out of 9,294 hotspots were prioritized by mapping newly identified PLHIV by residential addresses. Over 22 weeks, among 882,449 individuals screened using HRST, 723,993 (82.0%) were eligible and tested for HIV (state range, 43.7– 90.4%), out of which 20,616 were positive. Through IT, an additional 3,724 PLHIV were identified. In total, 24,340 PLHIV were identified and 97.4% were linked to life-saving antiretroviral therapy. The number of newly identified PLHIV increased 17-fold over 22 weeks (week 1: 89; week 22: 1,632). Overall mean HIV positivity rate by state was 3.3% (range, 1.8–6.4%). Conclusion: Using ECCP in nine states in Nigeria increased the number of PLHIV in the community who knew their status, allowing them to access life-saving care and decreasing the risk of HIV transmission.
AB - Purpose: The 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) showed Nigeria’s progress toward the UNAIDS 90-90-90 targets: 47% of HIV-positive individuals knew their status; of these, 96% were receiving antiretroviral therapy (ART); and of these, 81% were virally suppressed. To improve identification of HIV-positive individuals, Nigeria developed an Enhanced Community Case-Finding Package (ECCP). We describe ECCP implementation in nine states and assess its effect. Methods: ECCP included four core strategies (small area estimation [SAE] of people living with HIV [PLHIV], map of HIV-positive patients by residence, HIV risk-screening tool [HRST], and index testing [IT]) and four supportive strategies (alternative healthcare outlets, performance-based incentives for field testers, Project Extension for Community Healthcare Outcomes, and interactive dashboards). ECCP was deployed in nine of 10 states prioritized for ART scale-up. Weekly program data (October 2019–March 2020) were tracked and analyzed. Results: Of the total 774 LGAs in Nigeria, using SAE, 103 (13.3%) high-burden LGAs were identified, in which 2605 (28.0%) out of 9,294 hotspots were prioritized by mapping newly identified PLHIV by residential addresses. Over 22 weeks, among 882,449 individuals screened using HRST, 723,993 (82.0%) were eligible and tested for HIV (state range, 43.7– 90.4%), out of which 20,616 were positive. Through IT, an additional 3,724 PLHIV were identified. In total, 24,340 PLHIV were identified and 97.4% were linked to life-saving antiretroviral therapy. The number of newly identified PLHIV increased 17-fold over 22 weeks (week 1: 89; week 22: 1,632). Overall mean HIV positivity rate by state was 3.3% (range, 1.8–6.4%). Conclusion: Using ECCP in nine states in Nigeria increased the number of PLHIV in the community who knew their status, allowing them to access life-saving care and decreasing the risk of HIV transmission.
KW - ART Surge
KW - HIV risk assessment tool
KW - Index partner testing
KW - Small area estimation
UR - http://www.scopus.com/inward/record.url?scp=85113917961&partnerID=8YFLogxK
U2 - 10.2147/HIV.S316480
DO - 10.2147/HIV.S316480
M3 - Article
AN - SCOPUS:85113917961
SN - 1179-1373
VL - 13
SP - 839
EP - 850
JO - HIV/AIDS - Research and Palliative Care
JF - HIV/AIDS - Research and Palliative Care
ER -