Impact of clinic environments and engagement in human immunodeficiency virus care in nigeria
1
SDG Alliance, Yola, Adamawa, Nigeria
2
Society for Family Health, Kano, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
access to human immunodeficiency virus (hiv) services does not guarantee sustained engagement in care. in many low-resource settings, how services are delivered can discourage continued use, even when treatment is available. In nigeria, hiv services are often centralised in a small number of public facilities, leading to overcrowding, long waiting times, and limited privacy. this study examined how clinic environments influence decisions to initiate, delay, or remain engaged in hiv treatment services.
METHODS:
a mixed-methods study was conducted between june-september 2025 in 2 public hiv treatment clinics in adamawa. Interviews were conducted with 72 people living with human immunodeficiency virus who had accessed testing, counselling, or antiretroviral treatment within the previous two years. Participants included newly diagnosed clients and individuals established in care. Interviews explored waiting times, privacy, counselling experiences, provider–client interactions, and subsequent care-seeking decisions. descriptive counts were used to summarise key clinic experiences, while qualitative data were analysed thematically.
RESULTS:
out of 72 participants, 58 reported spending more than two hours per clinic visit, with waiting times of up to five hours commonly reported in the highest-volume clinic. Lack of adequate auditory or visual privacy during counselling was described by 51 participants, including reports of interruptions and conversations being overheard. thirty-nine participants described provider–client interactions as rushed or unfriendly. These clinic-level factors influenced engagement in care, with 31 reporting delayed follow-up visits, missed appointments, or avoidance of services due to long waiting times, confidentiality concerns, or previous negative experiences. disengagement was reported most often by clients attending the most centralised facility.
CONCLUSIONS:
clinic organisation and environment strongly influence sustained engagement in hiv care. long waiting times, inadequate privacy, and overstretched staff contribute to delayed follow-up and missed visits. strengthening clinic infrastructure, improving efficiency, and decentralising services may help protect retention in care and improve long-term treatment outcomes.
access to human immunodeficiency virus (hiv) services does not guarantee sustained engagement in care. in many low-resource settings, how services are delivered can discourage continued use, even when treatment is available. In nigeria, hiv services are often centralised in a small number of public facilities, leading to overcrowding, long waiting times, and limited privacy. this study examined how clinic environments influence decisions to initiate, delay, or remain engaged in hiv treatment services.
METHODS:
a mixed-methods study was conducted between june-september 2025 in 2 public hiv treatment clinics in adamawa. Interviews were conducted with 72 people living with human immunodeficiency virus who had accessed testing, counselling, or antiretroviral treatment within the previous two years. Participants included newly diagnosed clients and individuals established in care. Interviews explored waiting times, privacy, counselling experiences, provider–client interactions, and subsequent care-seeking decisions. descriptive counts were used to summarise key clinic experiences, while qualitative data were analysed thematically.
RESULTS:
out of 72 participants, 58 reported spending more than two hours per clinic visit, with waiting times of up to five hours commonly reported in the highest-volume clinic. Lack of adequate auditory or visual privacy during counselling was described by 51 participants, including reports of interruptions and conversations being overheard. thirty-nine participants described provider–client interactions as rushed or unfriendly. These clinic-level factors influenced engagement in care, with 31 reporting delayed follow-up visits, missed appointments, or avoidance of services due to long waiting times, confidentiality concerns, or previous negative experiences. disengagement was reported most often by clients attending the most centralised facility.
CONCLUSIONS:
clinic organisation and environment strongly influence sustained engagement in hiv care. long waiting times, inadequate privacy, and overstretched staff contribute to delayed follow-up and missed visits. strengthening clinic infrastructure, improving efficiency, and decentralising services may help protect retention in care and improve long-term treatment outcomes.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
