A Scalable Model for National Expansion of HIV Self-Testing: Rapid Scale-Up of HIV Self-Testing Using a Total Market Approach in Nigeria
1
Clinton Health Access Initiative, Abuja Municipal, Nigeria
2
National AIDS and STDs Control Programme, Abuja Municipal, Nigeria
3
African Health Project, Abuja Municipal, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):A3718
ABSTRACT
BACKGROUND:
As Nigeria accelerates progress toward the UNAIDS 95-95-95 targets, scalable HIV-testing strategies that are integrated, ensure reach, data quality and linkage-to-care are urgently needed. HIV self-testing (HIVST) implemented through a Total-Market-Approach (TMA), has the potential to transform national testing systems. The Promoting Access to HIV-Self-Testing (PATHSII) project evaluated uptake of rapid HIVST scale-up across multiple channels. Description: Over 12 months, CHAI and NASCP, with state and private-sector actors implemented a TMA strategy across 23 channels: Community Pharmacies (CPs), Patent Proprietary Medicine Vendors (PPMVs), and Community-Based-Organizations (CBOs) in three Nigeria states (Kaduna, Nasarawa, and Ogun). Interventions included technical assistance (TA) to government, distribution channels selection using WHO tools, capacity building for private sector & states, provider capacity strengthening, and real-time monitoring of testing, reporting, referral and linkages. The data was collected using national tools.
RESULTS:
The program distributed 4,684 HIVST kits, achieving a 93% result reporting-rate. Reactivity was 1.3%, with 98% of reactive linked to confirmatory testing and 85% initiated-ART. The project demonstrated expanded access, a breakthrough in male engagement with approximately 50% distribution of HIVST kits between men, 2339(49.9%) and women, 2345(50.1%), while maintaining accountability and quality. Implementation across sites proved feasibility of private-sector integration adaptable across diverse geographic and epidemiological contexts. Regionally, Nasarawa achieved the highest reporting (96%), Kaduna showed highest confirmed positivity (95%). Overall, the 85% ART-initiation rate among confirmed positives validates efficiency. The project demonstrated state actors successfully overseeing private sector HIVST distribution.
CONCLUSIONS:
HIVST delivered through a TMA can expand testing coverage while preserving strong linkage-to-care outcomes. The findings provide timely, actionable evidence to inform national HIV testing policies and position HIVST as a central pillar of epidemic control in Nigeria and similar settings. The synergy between public oversight and private-sector delivery creates a sustainable health system with potential to transition to full national scale-up.
As Nigeria accelerates progress toward the UNAIDS 95-95-95 targets, scalable HIV-testing strategies that are integrated, ensure reach, data quality and linkage-to-care are urgently needed. HIV self-testing (HIVST) implemented through a Total-Market-Approach (TMA), has the potential to transform national testing systems. The Promoting Access to HIV-Self-Testing (PATHSII) project evaluated uptake of rapid HIVST scale-up across multiple channels. Description: Over 12 months, CHAI and NASCP, with state and private-sector actors implemented a TMA strategy across 23 channels: Community Pharmacies (CPs), Patent Proprietary Medicine Vendors (PPMVs), and Community-Based-Organizations (CBOs) in three Nigeria states (Kaduna, Nasarawa, and Ogun). Interventions included technical assistance (TA) to government, distribution channels selection using WHO tools, capacity building for private sector & states, provider capacity strengthening, and real-time monitoring of testing, reporting, referral and linkages. The data was collected using national tools.
RESULTS:
The program distributed 4,684 HIVST kits, achieving a 93% result reporting-rate. Reactivity was 1.3%, with 98% of reactive linked to confirmatory testing and 85% initiated-ART. The project demonstrated expanded access, a breakthrough in male engagement with approximately 50% distribution of HIVST kits between men, 2339(49.9%) and women, 2345(50.1%), while maintaining accountability and quality. Implementation across sites proved feasibility of private-sector integration adaptable across diverse geographic and epidemiological contexts. Regionally, Nasarawa achieved the highest reporting (96%), Kaduna showed highest confirmed positivity (95%). Overall, the 85% ART-initiation rate among confirmed positives validates efficiency. The project demonstrated state actors successfully overseeing private sector HIVST distribution.
CONCLUSIONS:
HIVST delivered through a TMA can expand testing coverage while preserving strong linkage-to-care outcomes. The findings provide timely, actionable evidence to inform national HIV testing policies and position HIVST as a central pillar of epidemic control in Nigeria and similar settings. The synergy between public oversight and private-sector delivery creates a sustainable health system with potential to transition to full national scale-up.
| eISSN: | 2654-1459 |
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