About 3.4million people are living with HIV in Nigeria Estimated AIDS related deaths in Nigeria moved from 141,225 in 2000 to 233,604 in 2013. This is associated with ignorance, poor access to health and social services, poverty, gender issues, stigma and discrimination. According to NARHS, 2012, the current HIV prevalence in the general population is 3.4%. There was a slight decline from the previous estimates of 2007 which was 3.6%

1. Lessons Learned in Providing Reproductive Health and
HIV Prevention program for People Who Inject Drugs In
Urban Slum in Oyo State South West Nigeria
Bako J. C, Titus M.O, Tijani A.I, Oni F, Atoyebi O,
Omoreigie G, Oyedeji D, Tomori O.T, Ademodi T, Fashade A
Society for Family Health
Goodworker Ministry International
National HIV Prevention Conference
November, 2016
…Creating Change, Enhancing LivesSociety for Family Health, Nigeria

2. Background
• About 3.4million people are living with HIV in Nigeria
• Estimated AIDS related deaths in Nigeria moved from
141,225 in 2000 to 233,604 in 2013.
• This is associated with ignorance, poor access to health and
social services, poverty, gender issues, stigma and
discrimination.
• According to NARHS, 2012, the current HIV prevalence in
the general population is 3.4%.
• There was a slight decline from the previous estimates of
2007 which was 3.6%
…Creating Change, Enhancing LivesSociety for Family Health, Nigeria

3. Background Contd.
• HIV prevalence was highest in Oyo state among
the South-west states with prevalence of 5.6%
(NARHS 2012)
• According to 2008 mode of transmission studies,
majority of the infections in Nigeria are due to
HIV transmission within the general population
…Creating Change, Enhancing LivesSociety for Family Health, Nigeria

4. Background Contd.
• However, the high risk groups who makes up about 1% of the adult
populations contribute almost 23% of new HIV infections and with
their partners contributes 40% while FSWs and their clients
contributes half of the infections.
• MSM, PWID and their partners contributes about 10% and 9% of the
new infections
…Creating Change, Enhancing LivesSociety for Family Health, Nigeria

5. Program with PWID
 Society for Family Health with Funding support from the Global
Fund implemented HIV Prevention program in Oyo state under the
New Funding Model for MARPs (PWID) with the aim to:
• Reduce new HIV infections, and improve the quality of life for the infected and
affected
• Provide Nigerians with universal access to high-quality, patient-centred
prevention, diagnosis, and treatment services for TB, TB/HIV, and drug-
resistant TB by 2020, and
• Contribute to the restoration of public confidence in primary health care
services in Nigeria, and thereby reverse declines in the utilization of primary
health care facilities
Society for Family Health, Nigeria

6. …Creating Change, Enhancing LivesSociety for Family Health, Nigeria …Creating Change, Enhancing LivesSociety for Family Health, Nigeria
Program with PWID Contd.
• SFH through Partnerships Assessment and Organizational Development
Framework worked with SACA and SMoH to select KAP led/friendly
organizations to work with PWID in Oyo State
• GF HIV NFM Prevention Programs among the MARPs aligned with the HCT,
Condom Promotion and communication Interventions of the National Strategic
Plan (NSP 2010 - 2015) for HIV prevention contributing to 4 indicators
• 80% of sexually active adults accessing HTS in sustainable way.
• 80% MARPs accessing HTS by 2015
• 80% MARPs use condoms in the right way always.
• 80% MARPs reached with group specific interventions and adopt appropriate
HIV/AIDS behaviour.

7. …Creating Change, Enhancing LivesSociety for Family Health, Nigeria …Creating Change, Enhancing LivesSociety for Family Health, Nigeria
Program with PWID Contd.
• SFH adopts Minimum Prevention Package Intervention (MPPI) as the programme
strategy for the MARPs to meet their current HIV prevention needs by reducing
new infections
 Behavioural Intervention
o 40 PWID Recruited and trained as Peer Educators
o 320 PWID reached with MPPI
o 2,704 IEC materials distributed during sessions
o 23,582 condoms and 50 lubricants were distributed
 Bio-Medical Intervention
o 245 PWID reached with HTS
o 4 referred for STI services
o Condom forecasting and quantification
o 2 PWID referred for TB treatment

8. …Creating Change, Enhancing LivesSociety for Family Health, Nigeria …Creating Change, Enhancing LivesSociety for Family Health, Nigeria
Program with PWID Contd.
Structural Intervention
o Series of meeting with key stakeholders and influencers to address
wide range of issues
o Advocacy meeting with the law enforcement agencies
o Joint quarterly community town hall meeting with KAPs

9. …Creating Change, Enhancing LivesSociety for Family Health, Nigeria …Creating Change, Enhancing LivesSociety for Family Health, NigeriaSociety for Family Health, Nigeria …Creating Change, Enhancing Lives
Lessons Learned
• Condom use with sexual partners is very low, the same applies to
knowledge and awareness on STIs and HIV prevention among
PWID in intervention communities.
• Most sexually active PWID in Oyo state have non-injecting sex
partners thereby increasing the potential for STI/HIV infection
among non-injecting population
• 95% of PWID who went through the program are poor, they lack
social and economic power and often look for cheaper means of
taking drugs (selling sex or sharing needles/syringes).
• Sharing of needles/syringes is a common practice among poor
PWID in Oyo state.
• Lack of awareness and education about safe injecting is a major
reason for sharing needles including PWID’s perception that it is a
social and cultural norm, and that it strengthens bonding
•

10. …Creating Change, Enhancing LivesSociety for Family Health, Nigeria …Creating Change, Enhancing LivesSociety for Family Health, NigeriaSociety for Family Health, Nigeria …Creating Change, Enhancing Lives
Lessons Learned Contd.
• PWID are willing and ready to be tested for STI or HIV but are not
ready to spend money on further tests, drugs or treatment
• PWID are more comfortable disclosing and discussing their health
issues with trained HCWs after their training on how to provide
friendly services to KAP
• Most young women who inject drugs in Oyo state cover up their
drug taking behavior and are unwilling to participate in prevention
programme because of societal discrimination - limiting their
access to medical care and HIV services
• PWID encounters stigma and discrimination from the society since
they involve in stealing and lies to support their drug habit. This
action contribute to ongoing HIV epidemics as PWID fail to access
harm reduction and other health services

11. Conclusions and Recommendations
• HIV prevention programs should be designed in a more
comprehensive way and identify the best venues to reach
the largest number of PWID in order to address risk
reduction and overlaps.
• It should focus on young PWID to prevent them from
starting to inject or help them to end their addiction if they
have already started
• Create window of opportunity for drug rehabilitation for
drug users
…Creating Change, Enhancing Lives
Society for Family Health, Nigeria

12. Conclusions and Recommendations Contd.
• Engage and train more HCWs on how to provide friendly
services to KAP to reduce stigma/discrimination and
provide additional support
• Develop an effective referral & tracking system for PWID
who screened and tested positive to STI/HIV
• Empower PWID through capacity building and involve
them actively in all advocacy and policy activities
• Set-up needle/syringe distribution and disposal
programs - remove legal, social, and funding barriers to
Needle and Syringe Programmes (NSPs) in Nigeria.
…Creating Change, Enhancing Lives
Society for Family Health, Nigeria

13. …Creating Change, Enhancing LivesSociety for Family Health, Nigeria …Creating Change, Enhancing LivesSociety for Family Health, Nigeria…Creating Change, Enhancing Lives
Society for Family Health, Nigeria
…Creating Change, Enhancing Lives

14. Thank You for your Attention
…Creating Change, Enhancing LivesSociety for Family Health, Nigeria