Title

Performance of oral versus blood-based HIVST cascade in Nigeria: unitaid-funded STAR programmatic experience

Presenter

Victor Abiola Adepoju

Authors

V.A. Adepoju¹, C. Umebido¹, Z. Hassan¹, I.-J. Dada², N. Chukwukaodinaka², A. Oniyire¹, C. Laube³, M. Strachan⁴, K. Grabbe³

Institutions

¹Jhpiego Nigeria, an affiliate of John Hopkins University, HIV and Infectious Diseases, Abuja, Nigeria, ²National AIDS/STI Control Program, Abuja, Nigeria, ³Jhpiego USA, HIV and Infectious Diseases, Baltimore, United States, ⁴Jhpiego USA, Baltimore, United States

BACKGROUND: As of August 2022, six HIV Self-testing (HIVST) have been prequalified by WHO (one oral fluid-based (OFB) and 5 blood-based (BB) products). In Nigeria, OraQuick HIVST kit was approved in 2019 while 4 additional BB HIVST kits were approved between 2020 and 2021. Jhpiego Nigeria implemented the Unitaid-funded STAR project between March 2020 and October 2022 testing several distribution models.
METHODS: The STAR project trained private and public facility service providers, community-based organizations and implementing partners on both oral and BB products and provided reporting tools. Between January 2021 and October 2022, OFB products were deployed for use in 12 Nigerian states and across facility, Key Population One-Stop-Shops, community and private pharmacies while BB products were deployed and used in community and private pharmacy models between July and October, 2022. Individuals with reactive HIVST were referred to a health facility for confirmatory testing and antiretroviral therapy (ART), individuals with negative results were referred to receive Pre-Exposure prophylaxis ( PrEP). Information on HIVST distribution, reported results, confirmatory HTS, ART and PrEP linkage were documented in relevant register, aggregated and reported on DHIS2.
RESULTS: From January 2021 to October, 2022, a total of 183,814 oral-based HIVST kits were distributed, 180,745 (98.3%) results were reported, 4729 (2.6%) HIVST reactive, 4,533 (95.9%) of them attended confirmatory HTS, 4,389 (96.8%) were confirmed and 4,346 (99%) linked to ART, 17013 (9.7%) of negative Self-test users started on PrEP. Between July and October, 2022, a total of 16,211 blood-based HIVST were distributed, 15,697 (96.8%) results were reported, 121(0.8%) HIVST reactive, of which 63 (52.1%) attended confirmatory HTS, 61 (96.8%) were confirmed and 61 (100%) linked to ART. 792 (5.1%) of negative Self-test users started on PrEP.
CONCLUSIONS: Similar cascade performance of blood- and oral-based HIVST self-test users in Nigeria with the exception of attendance at confirmatory testing which was poorer for BB self-test users. We observed very high linkage rates for both, BB and OFB HIVST users and high uptake rates for both, treatment and care as well as for PrEP.

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