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Achieving HIV epidemic control through integrated community and facility-based strategies: Lessons learnt from ART-surge implementation in Akwa Ibom, Nigeria

This study examines the lessons learnt from the implementation of a surge program in Akwa Ibom State, Nigeria as part of the Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS) Project. In this analysis, we included all clients who received HIV counseling and testing services, tested HIV...

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Detalles Bibliográficos
Autores principales: Nwaokoro, Pius, Sanwo, Olusola, Toyo, Otoyo, Akpan, Uduak, Nwanja, Esther, Elechi, Iheanyichukwu, Ukpong, Kufre-Abasi, Idiong, Helen, Gana, Bala, Badru, Titilope, Idemudia, Augustine, Ogbechie, Matthew-David, Imohi, Philip, Achanya, Anthony, Oqua, Dorothy, Kakanfo, Kunle, Olatunbosun, Kolawole, Umoh, Augustine, Essiet, Patrick, Usanga, Ime, Ezeanolue, Echezona, Obiora-Okafo, Chika, James, Ezekiel, Iyortim, Isa, Chiegil, Robert, Khamofu, Hadiza, Pandey, Satish Raj, Bateganya, Moses
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9770335/
https://www.ncbi.nlm.nih.gov/pubmed/36542606
http://dx.doi.org/10.1371/journal.pone.0278946
Descripción
Sumario:This study examines the lessons learnt from the implementation of a surge program in Akwa Ibom State, Nigeria as part of the Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS) Project. In this analysis, we included all clients who received HIV counseling and testing services, tested HIV positive, and initiated ART in SIDHAS-supported local government areas (LGAs) from April 2017 to March 2021. We employed descriptive and inferential statistics to analyze our results. A total of 2,018,082 persons were tested for HIV. Out of those tested, 102,165 (5.1%) tested HIV-positive. Comparing the pre-surge and post-surge periods, we observed an increase in HIV testing from 490,450 to 2,018,082 (p≤0.031) and in HIV-positive individuals identified from 21,234 to 102,165 (p≤0.001) respectively. Of those newly identified positives during the surge, 98.26% (100,393/102,165) were linked to antiretroviral therapy compared to 99.24% (21,073/21,234) pre-surge. Retention improved from 83.3% to 92.3% (p<0.001), and viral suppression improved from 73.5% to 96.2% (p<0.001). A combination of community and facility-based interventions implemented during the surge was associated with the rapid increase in case finding, retention, and viral suppression; propelling the State towards HIV epidemic control. HIV programs should consider a combination of community and facility-based interventions in their programming.