BACKGROUND: Since 2007, Clinton Health Access Initiative (CHAI) has introduced several transformational interventions to improve access to optimal HIV diagnostics, treatment, and technologies. To enhance community engagement in HIV interventions, Unitaid and CHAI partnered with Afrocab Treatment Access Partnership (Afrocab) in 2016 to develop activities centered on improving treatment literacy among people living with HIV (PLHIV) and driving the uptake of optimal HIV products through the Optimal community advisory board (Optimal CAB).
DESCRIPTION: At the inception of the Optimal project funded by Unitaid, CHAI supported the Optimal CAB to implement community engagement activities across 56 health facilities in 12 states within Nigeria. The key deliverables of the Optimal CAB were (i) to facilitate optimal product adoption, (ii) to improve treatment literacy among PLHIV on optimal products to generate demand, and (iii) obtain feedback from PLHIV on optimal products to inform policy. CHAI provided evidence on optimal products while Optimal CAB members disseminated this information to the community.
LESSONS LEARNED: The Optimal CAB supported the adoption and uptake of 9 HIV products in Nigeria: Tenofovir-Lamivudine-Dolutegravir, Lopinavir/ritonavir pellets, Pediatric Dolutegravir (pDTG), Darunavir/ritonavir, Liposomal Amphotericin B, Flucytosine, VISITECT, CrAg Lateral Flow Assay, and TB-LAM. Optimal CAB advocacy contributed to the recommendation of DTG as the preferred first-line antiretroviral regimen, and over 1.6 million people are now on DTG-based regimens in Nigeria.
On product uptake, the Optimal CAB has produced and disseminated 14 print and 5 audiovisual Information Education and Communication materials on HIV services to 54% (20) of states in Nigeria. Optimal CAB members trained 56 adherence counsellors on AHD and 148 mentor mothers on pDTG, disseminated information that debunked myths resulting in equitable and increased access to DTG among women, supported tracking of HIV services and facilitated drug delivery during the COVID-19 movement restriction.
Optimal CAB observed low ADRs and OIs reporting rates, hence built PLHIV capacity to report these for appropriate management.
CONCLUSIONS: Community engagement has become a pillar of HIV programming in Nigeria and should be integrated into HIV interventions. More critically, the engagement should be targeted at treatment literacy on optimal HIV services to achieve better treatment outcomes.

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