By Ojoma Akor
A same-day test-and-start strategy in Rivers state, Nigeria, is transforming HIV care, the Institute of Human Virology Nigeria’s ASPIRE Project Director, Dr. Stanley Idakwo, has said.
He said this enables clients to begin treatment immediately and improve viral suppression rates.
He also said the approach, aligned with national guidelines, ensures that patients are quickly identified, counseled, and placed on treatment, leading to better health outcomes and reduced HIV-related complications.
He said, “The same-day test-and-start approach involves identifying clients, counseling them, and commencing treatment immediately. This strategy has significantly reduced the mortality and morbidity associated with HIV.
He explained that clients receive antiretroviral drugs free of charge, making same-day treatment possible. “We closely monitor clients, follow them up, and provide treatment for opportunistic infections such as tuberculosis. For clients diagnosed with tuberculosis, treatment begins immediately, and antiretroviral therapy is initiated after two weeks,” he added.
Dr. Idakwo emphasized that clients are not left to navigate treatment on their own. “When clients start treatment, they are provided with continuous follow-up and adherence support. During the initial 28-day period, clients are closely monitored with follow-ups on days 3, 7, 14, 21, and 28. During these visits, we assess their concerns, monitor for adverse drug reactions, evaluate their overall well-being, and identify any barriers to adherence.”
Solutions are developed collaboratively with clients, reflecting the second strategy: a client-centered approach that treats each individual as a person, not just as part of a group, Dr. Idakwo explained.
He added that the IHVN ASPIRE Project also employs a “team-of-teams” approach, comprising both facility-led and community-led teams, each guided by designated leaders. These cascade management teams work together to identify clients, retain them in care, and address challenges such as access to medication, stigma, or missed appointments. Continuous follow-up is a key component of this process, he said.
Another important strategy, according to Dr. Idakwo, is collaboration with community structures such as ward and village committees. Through sustained advocacy, these groups help raise awareness about HIV, encourage people to know their status, and ensure that individuals who test positive are promptly linked to care and closely followed up.
In addition, the project works closely with the supply chain team to guarantee the continuous availability of medicines and prevent treatment interruptions. “Clients access treatment at no cost, remain healthy, and continue on lifelong therapy that supports their long-term well-being,” Dr. Idakwo concluded.
Supported by PEPFAR through the U.S. Centers for Disease Control and Prevention, the ASPIRE Project works across four Nigerian states to advance HIV epidemic control by strengthening laboratory systems, expanding prevention and treatment services, improving quality of care, and delivering comprehensive, community-based support.
The Rivers State intervention began in 2019 after the 2018 NAIIS identified the state as a priority, with the highest unmet need for HIV services and a prevalence of 3.8%, well above the national average of 1.4%.
