Applying Lessons from Early-Stage Voluntary Counseling and Testing Services to End the HIV/AIDS Epidemic in Nigeria by 2030

Abstract

Nigeria has waded through the HIV/AIDS epidemic for more than 35 years now since 1986. Response efforts are down-grading the epidemic from a peak of 5.8% prevalence in 2010 to a decline of 1.4% prevalence in 2019. Nigeria is desirous of ending the HIV/AIDS epidemic by 2030, but the terrain is challenged by bleak economic outlook and socio-political shocks that impose vulnerability including insurgency. This study explores the feasibility of Nigeria ending the HIV/AIDS epidemic by the year 2030, applying evaluation, management by objective (MBO), content analysis and the deductive model to assess early stage Voluntary Counseling and Testing (VCT) services in Anambra State, South-East Nigeria for the period 2006 - 2011. Secondary data were collected comprising summary of client flow activities of all 117 VCT centers in the State. Content analysis and deductive model were applied on the data to derive lessons learnt. The study found that: (i) VCT services were beneficial to about 1.9% of the State population, though with gross capacity under-utilization of VCT centers at 2.7 clients/day and the under-utilization of counselors at 0.6 clients served/day arising from low client flow; (ii) counseling process was effective and efficient in persuading consent to test; (iii) routine and mass HIV testing were cost-effective in detecting HIV positive sero-status; (iv) the synergy arising from counseling, testing and referral effectively mobilized Persons Living with HIV/AIDS for improved knowledge, attitude and practice (KAP) including formation of support groups averaging approximately 2 support groups per Local Government Area. The study recommends that VCT be adapted to a universal counseling and testing paradigm that includes, among others, outreach counseling and testing sessions, on-line counseling, and help-line supported self-testing. The study concludes that with necessary adjustment in counseling and testing, as well as necessary adjustments in other HIV/AIDS prevention, care and support services, the objective of ending the HIV/AIDS epidemic in Nigeria by 2030 will be attained.