Accelerating HIV epidemic control in Benue state, Nigeria, 2019-2021: the APIN program experience.

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• HIV/AIDS Research

Background:

• Nigeria faces a substantial HIV burden, ranking fourth globally, with significant geographical disparities in prevalence.
• Benue State exhibits the second-highest HIV prevalence in Nigeria, with a considerable gap in antiretroviral treatment (ART) coverage.
• A gap of 320,921 individuals needing ART existed nationally, with Benue State accounting for 35,623 PLHIV in 2018.

Purpose of the Study:

• To describe the strategic approaches employed during the Benue ART surge (BAS).
• To demonstrate the progress made in expanding access to ART for people living with HIV (PLHIV) in Benue State.
• To evaluate the impact of the BAS on HIV case identification and ART initiation.

Main Methods:

• The BAS intervention was implemented across 252 health facilities from May 2019 to September 2021.
• Data collection utilized an Excel-based dashboard and electronic medical records for tracking key indicators.
• Analysis focused on trends in HIV case identification, ART initiation, viral load suppression, and treatment interruption rates.

Main Results:

• Out of 893,462 clients reached, 6.7% were diagnosed with HIV, and 99.8% initiated ART.
• HIV case identification surged by 467% from baseline, peaking in August 2020.
• Viral load testing coverage increased to 95%, and viral load suppression reached 96%.

Conclusions:

• The BAS implementation enhanced access to comprehensive HIV services in Benue State.
• Significant increases in HIV case identification and ART initiation substantially reduced the state's HIV treatment gap.
• Lessons from the BAS should inform and scale up Nigeria's national HIV program to achieve UNAIDS 95-95-95 goals.