Reaching out to the hard-to-reach populations with HIV self-testing services in South-south Nigeria

Introduction: Despite decades of knowledge and advances in human immunodeficiency virus (HIV) management and treatment, many populations are being left behind and not accessing HIV Testing Services (HTS) to the fullest possible extent. The saliva-using tool OralQuick®, easy to use, non-invasive, with assurances of confidentiality and privacy, could revolutionize HTS. Objective: The aim of the study was to assess the impact of the total market approach being deployed in Cross River and Akwa Ibom States in South-south Nigeria to enhance the demand for HIV Self-Testing (HIVST), to ensure product equity, accessibility and sustainability Material and methods: This study was a retrospectivecross-sectional study involving analysis of HIVST records in community pharmacies and community anti-retroviral (ARV) management (CAM) teams in Cross River and Akwa Ibom States Nigeria, from March – December 2020. Different metrics, such as the offer of the HIVST kits, acceptance, reactivity, and linkage to HIV management and prevention services, were assessed and analyzed. Results: A total of 5,153 eligible clients were offered the HIV testing service, with an acceptance rate of 23.4% (1,207), of which 33.3% (402) clients were assisted and 66.7% (805) were unassisted. Of the 1,207 who accepted the offer of the test, 963 (79.8%) reported their results, and 39 (4%) reported reactive results. On linkage for confirmatory testing and HIV care and treatment, all the 39 clients were initiated, while 586 (71%) who were non-reactive to HIVST accessed HIV prevention services. Conclusions: The human immunodeficiency virus self-testing model has demonstrated the potential to be a vital tool in expanding the HIV testing services, and linkage to HIV care services to populations who would otherwise not have been tested