AF3 HIV Counseling and Testing and Access-to-Care Needs of Populations Most-at-Risk for HIV in Nigeria.

Ahmed, Saidu; Delaney, Kevin; Villalba-Diebold, Pacha; Aliyu, Gambo; Constantine, Niel; Onoja, Ali; Vertefeuille, John; Blattner, William; Nasidi, Abdulsalami; Charurat, Man
JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/01.qai.0000413823.42426.99

Objective: Mobile HIV counseling and testing (mHCT) is an effective tool to access hard-to-reach most-at-risk populations (MARPs), but identifying which populations are not accessing services is often a challenge. We compared correlates of HIV infection and awareness of HIV care services among populations tested through mHCT and at testing facilities in Nigeria.

Design: Participants in a cross-sectional study completed a questionnaire and HIV counseling and testing between May 2003 and March 2010.

Results: Of 27,586 total participants, 26.7% had been previously tested for HIV; among mHCT clients, 14.7% had previously tested. HIV prevalence ranged from 6.6% among those tested through a facility to 50.4% among brothel-based sex workers tested by mHCT. Among mHCT participants aged 18-24, women were 9.0 times more likely to be infected than men. Women aged 18-24 were also less likely than their male counterparts to know that there were medicines available to treat HIV (63.2% vs 68.1%; P = 0.03). After controlling for gender, age and other risk factors, those with current symptoms of genital ulcers were more likely to be HIV-infected (ORmHCT = 1.65, 1.31-2.09; ORfacility = 1.71, 1.37-2.14), while those previously tested were less likely to be HIV-infected (ORmHCT = 0.75, 0.64-0.88; ORfacility = 0.27, 0.24-0.31).

Conclusions: There is an urgent need to promote strategies to identify those who are HIV-infected within MARPs, particularly young women, and to educate and inform them about availability of HIV testing and care services. mHCT, ideally coupled with STI management, may help to ensure that MARPs access HIV prevention support, and if infected, access care and treatment.

(C) 2012 Lippincott Williams & Wilkins, Inc.