Halting the Scourge of HIV in Nigeria by Adopting World Health Organization Guidelines for Preventing New Infections (Policy Brief Paper)

Abstract

Nigeria bears 10% of global HIV burden and contributes 32% to global unmet-need for Prevention of Mother to Child transmission of HIV (PMTCT), which together with heterosexual transmission are the epidemic’s key drivers as PMTCT clinics show approximately 45% serodiscordance rates among couples. WHO recommends accelerated Anti-retroviral Therapy initiation for all persons living with HIV (PLHIV) for improved quality-of-life and preventing new vertical and horizontal infections, using same drug – Emtricitabine, Tenofovir and Efaverenz (once daily Atripla). The policy paper seeks to make a case that the National PMTCT task team and the Federal Ministry of health of Nigeria, should make a policy change, and shift from the current Option B PMTCT option. The option provides Antiretroviral drugs (ARVs) to pregnant HIV positive women who do for PMTCT, but discontinue them after cessation of breast-feeding, when the viral load is above 500cells/mm³. It proposes that the country should rather adopt the test and treat all policy for all HIV infected persons. The methodology entails the search and use of literature to demonstrate the multiple advantages of early commencement of treatment for all new of HIV infections, considering this has been shown to reduce morbidity and mortality. The results indicate that test and treat all for life, is now less complex as same drug regimen are used in PMTCT and other non PMTCT adult infections. Studies also show that virologic suppression (undetectable) leads to prevention of new HIV transmission (untransmitable), and this applies to different modes of HIV transmission. The brief concludes by proposing that the Federal Ministry of Health, the National AIDS Control agency, and all actors in Nigeria’s HIV terrains should adopt the WHO test and treat guidelines. This remains a critical step for the elimination of Paediatric HIV infections.