MHRP Nigeria, known locally as the Walter Reed Program-Nigeria, has cultivated a strong partnership with the Nigerian Armed Forces to implement a comprehensive HIV prevention, care and treatment program supported by PEPFAR. Since MHRP began working in Nigeria in 2005, the program has developed leadership, clinical, laboratory and logistical capabilities within both military and civilian populations to strengthen health systems and infrastructure for long term sustainability.
In an effort to enhance capacity and improve service delivery to prevent HIV transmission and ensure viral load suppression, MHRP supports HIV testing and antiretroviral treatment programs at Nigerian Ministry of Defence (NMOD) health facilities and barrack communities. In coordination with a local partner, the program engages members of Key Populations (KP) and their partners with a comprehensive package of clinical and community-based prevention, care and treatment services in Lagos and Rivers States.
The program's strong partnership with the Nigerian military and its large network of medical facilities and well-trained personnel creates a supportive climate and framework for program evaluations, surveillance and research. Research conducted by MHRP in outreach to KPs has led to targeted programmatic interventions for KPs in the broader PEPFAR program.
The Nigeria NMOD program’s care and treatment activities are enhanced through a soldier-oriented support group for people living with HIV. The group provides psycho-social support to its members, has set up economic strengthening activities and has support from military wives. The group has helped eliminate stigma towards people living with HIV, which has led to better integration in the community.
Patient Engagement Survey for Key Populations
In 2020, USMRD-A Nigeria developed a patient engagement survey piloted with 200 clients accessing HIV prevention, testing, or treatment services, which will roll out country-wide in early 2021. This survey helps ensure that members of key populations, who are at increased risk for HIV infection, are being heard and receive high quality and non-judgmental services when accessing health care facilities. The results of the survey inform program and facility leadership of the potential gaps in quality of services, allowing them to course-correct to better serve their clients.
Social Media Outreach
The program partners with local organizations who leverage the power of social media to reach key populations, working with influencers, bloggers, dating sites and others. Through these digital platforms, the program is able to reach KPs who would otherwise be inaccessible through traditional KP interventions. Social media outreach provides KPs with crucial information on prevention and includes referrals to specific services needed by the users including pre-exposure prophylaxis, HIV testing, STI screening and treatment.
MHRP conducted a research study in Nigeria that showed drop-in community centers can be an effective model for prevention, care and treatment of HIV within key populations. The community health center, or One-Stop Shop (OSS), serves as a safe space for HIV and STI prevention, testing and treatment, but also offers other services including psychosocial counseling, cervical cancer screening and behavior change communication. The center is primarily run by clinicians with support staff including members of the community.
Community ART teams expand the reach of the OSS in the community, offering a wide range of prevention, care and treatment services, so most clients do not have to go into a physical office. This model has shown promising results and plans are underway to expand the network to ensure safe access to high quality services to a larger section of KPs across Nigeria.
Community advisory boards, composed of representatives from KPs and other key stakeholders, inform and monitor the work of the OSS and the community ART teams, ensuring that all services are in line with the needs of the populations served.