Abstract

BackgroundDespite Nigeria’s high HIV prevalence, voluntary testing and counselling rates remain low. UNAIDS/WHO/CDC recommends provider-initiated testing and counselling (PITC) for HIV in settings with high HIV prevalence. We aimed to assess the acceptability and logistical feasibility of the PITC strategy among adolescents and adults in a secondary health care centre in Idekpa Benue state, Nigeria.MethodAll patients (aged ≥ 13 years) who visited the out-patient department and antenatal care unit of General Hospital Idekpa, Benue state, Nigeria were offered PITC for HIV. The intervention was implemented by trained health professionals for the period spanning (June to December 2010).ResultsAmong the 212 patients who were offered PITC for HIV, 199 (94%) accepted HIV testing, 10 patients (4.7%) opted out and 3 patients (1.4%) were undecided. Of the 199 participants who were tested for HIV, 9% were HIV seropositive. The PITC strategy was highly acceptable and feasible, and increased the number of patients who tested for HIV by 5% compared to voluntary counselling and testing. Findings from this assessment were consistent with those from other sub-Saharan African countries (such as Uganda and South Africa).ConclusionPITC for HIV was highly acceptable and logistically feasible, and resulted in an increased rate of HIV testing among patients. Public health initiatives (such as the PITC strategy) that facilitate early detection of HIV and referral for early treatment should be encouraged for broader HIV control and prevention in Nigerian communities.

Highlights

  • Despite Nigeria’s high Human immunodeficiency virus (HIV) prevalence, voluntary testing and counselling rates remain low

  • Public health initiatives that facilitate early detection of HIV and referral for early treatment should be encouraged for broader HIV control and prevention in Nigerian communities

  • The introduction of the provider-initiated testing and counselling (PITC) strategy increased the number of patients who tested for HIV in the health facility compared to the voluntary counselling and testing (VCT) approach

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Summary

Introduction

Despite Nigeria’s high HIV prevalence, voluntary testing and counselling rates remain low. To increase the number of people who test for HIV, the Joint United Nations Programme on HIV/AIDS/World Health Organization (UNAIDS/WHO, including the Centre for Disease Control, CDC) recommends provider-initiated testing and counselling (PITC) strategy for all patients aged ≥ 13 years. Studies from Uganda [12], Zambia [13] and South Africa [14] found that PITC strategy (opt-out) increased the proportion of patients who tested for HIV and the number of patients who commenced anti-retroviral therapy. These studies showed that PITC was highly acceptable and feasible in the health facility. A study from Nigeria conducted among a cohort of university students found that the optout strategy was feasible and highly acceptable [15]

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