BACKGROUND:
Nigeria faces persistent gaps in HIV case finding, male engagement, and timely linkage to care, undermining progress toward the UNAIDS 95-95-95 targets. HIV self-testing (HIVST) offers a testing strategy capable of expanding access beyond traditional health facilities. PATHS II evaluated the epidemiological impact of scaled HIVST implementation across multiple service delivery channels. Description: From May–December 2025, HIVST was implemented across 23 sites in Kaduna, Nasarawa, and Ogun states using community pharmacies (CPs), patent and proprietary medicine vendors (PPMVs), and community-based organizations (CBOs). Site selection was guided by WHO adapted Standard Protocol Items: Recommendations for Interventional Trials (SPI-RIT) checklist to ensure quality. Activities included deployment of HIVST kits, capacity building for state actors, and establishing robust M&E systems for reporting testing, referral/linkage and ART initiation. Lessons Learnt: A total of 4,684 HIVST kits were distributed. The project achieved a 93% result reporting rate, substantially exceeding typical community HIVST benchmarks. Overall reactivity was 1.3% (56/4,684), with 98% of reactive clients linked to confirmatory HIV testing and 85% confirmed positives initiated on ART, demonstrating a highly efficient testing-to-treatment cascade. There was almost equal uptake of HIVSTs among men, 2339(49.9%) and women, 2345(50.1%) indicating HIVST’s effectiveness in addressing historically low male testing coverage. HIV positivity rates were higher among females than males (1.30% vs. 0.80%), with the highest positivity rates observed among women aged 30 years and older (1.7%) and adolescent girls aged 15–19 years (1.5%), highlighting the importance of gender-responsive prevention and linkage strategies. Conclusions/Next Steps: The findings provide epidemiological evidence that HIVST can support national HIV testing scale-up. Multi-channel HIVST distribution, particularly through the private sector (CPs/PPMVs) can effectively reach diverse age groups and maintain high integrity in the care cascade. At scale, HIVST via multiple distribution channels can achieve high reporting rates, effective case finding, and timely linkage to care.