Abstract:
Very high rates of late or no ART
initiation remains a persistent challenge to the achievement of
PEPFAR 95-95-95 targets despites new NAIIS report stating
prevalence of HIV in Nigeria as 1.5%. This study assessed the
impact of accompanied referral (AR) and effective counseling
(EC) on enrolment and ART treatment commencement of
newly diagnosed HIV positive patients.
Methods: This study is a Quasi- experimental and analyzed
routine program data on linkage from October 2017 – October
2019 for 45 health facilities in two States in South-West Nigeria.
The first 6 months (Q1 and Q2 FY18) had no intervention while
accompanied referral (AR) was implemented in Q3 and Q4
FY18. EC was implemented with AR in Q1&Q2 FY19 and was
followed up till Q3 and Q4 FY19. Data analysis was done using
SPSS and significance fixed at P < 0.05
Results: A total of 6114 newly identified HIV-positive clients
were identified; mean age was 35.7 ± 13.9 and 31.5% were in
the 30-39 years age bracket. Index Testing contributed 28.7%
of the HIV positive Clients identified. Percentage Enrolment in
Q1 and Q2FY18 increased from 65.8% and 65.6% respectively
to 89.9% and 83.8% in Q3 and Q4 FY18. This increased to
99.6% in Q1FY19, 100% in Q2, 99.7% in Q3 and 99.9% in
Q4FY19. Percentage linkage to ART in Q1 and Q2FY18
increased from 61.9% and 65.6% respectively to 85.4% and
75.7% in Q3 and Q4 FY18. This increased to 98.8% in Q1FY19,
99.5% in Q2, 99.7% in Q3 and 99.2% in Q4FY19.
Conclusion: AR coupled with EC had the best impact on
enrolment, initiation on ART, time to enrolment and initiation.
