HIV/AIDS Control Activities
ADSACA coordinated a gradual expansion of HIV/AIDS Service Delivery Points (SDPs) in Adamawa State over the past years. However, HFs that were able to deliver uninterrupted HIV/AIDS services were funded by Implementing Partners in the State. These include Family Health International 360 (FHI 360), Management Sciences for Health (MSH), AIDS Relief and Achieving Health Nigeria Initiative (AhNI). At the end of 2015, there were 95 functional HIV/AIDS service delivery points in Adamawa State; 12 of these delivered HIV/AIDS comprehensive services. Figure 1 below displays the gradual build-up of HIV/AIDS SDPs in Adamawa State.
Figure 1: Trend of HIV/AIDS Service Delivery Point Expansion in Adamawa State: 2011 to 2015
Tuberculosis is known to kill almost half of Persons Living with HIV/AIDS (PLHIV) while a significant number of TB cases are also co-infected with HIV. TB/HIV collaboration is an important thematic area in the control of HIV/AIDS. ADSACA also supports the Adamawa State TB Control Programme through provision of HIV Rapid Test Kits for timely screening of cough symptomatics and diagnosed TB Patients, and linkage to HIV/AIDS care and support.
HIV Counselling & Testing (HCT)
The entry point to HIV treatment, care and support is HCT. ADSACA has coordinated HCT activities in the State since its inception as can be seen in the trends below:
Figure 2: Trends of 0 – 14 years Individual Tested for HIV and Found HIV+ in Adamawa State 2009 -2014
The marked increase in individuals tested observed in 2014 was due to the involvement of implementing partners funded by the World Bank through the HPDP II project from 2014. A similar picture is observed among adults in the same intervention as seen in figure 3 below
Figure 3: Trends of 15years and above Individual Tested for HIV and Found HIV+ in Adamawa State 2009 – 2014
Prevention of Mother to Child Transmission (PMTCT):
This is one of the key interventions in the control of HIV where control efforts target the delivery of HIV free children by HIV infected mothers in the State. The chart below (figure 4) shows results of implementation of this activity over the past few years:
Figure 4: Trend of HIV+ Pregnant Women and those Receiving ARV to Reduce MTCT in Adamawa State 2009 -2014
ADSACA targets all HIV+ pregnant women for this intervention, unfortunately, due to suboptimal coverage in service delivery and inadequate drugs among other factors, this was not achieved from 2009 to 2013. With support from the World Bank through the HPDP II project, more HIV+ pregnant women were reached in 2014. The overshoot in those placed on treatment observed in 2014 was due to spill over of cases that presented for treatment long after they were diagnosed by the programme in the previous years. This could be attributed to improved information dissemination by implementing partners in 2014. Table 3 in the annex shows the result of the combined effort of all implementing partners in 2015 looking at selected variables.
The number of clients who had HCT in 2015 was 129,698 compared to 150,842 in 2014. Shortage of manpower, inadequate quantity of HIV Rapid Test Kits and consumables could have contributed to the reduction in clients who had HCT. Of all clients counselled, 4.7% were found to be HIV+. This could be an early predictor of Adamawa State Prevalence at this important period. The last prevalence in 2012 was 1.9% and the impact of insurgency in the State and other key factors could have changed the situation. Sexually Transmitted Infections (STI) remains a risk factor for the transmission of HIV. From the above table, over 2% of STI clients screened were found to be HIV+.
TB/HIV collaboration is an important thematic area for both diseases. Data obtained in 2015 shows that over 70% of HIV+ clients were found to be presumptive TB cases. They were referred for sputum microscopy in order to confirm if they had active TB. Unfortunately, there is no data on the number actually found to have active TB, neither is there data on those enrolled on TB treatment. The Agency would ensure that this gap is bridged in the coming year.
PMTCT is an important thematic area for HIV/AIDS control. Over 33,000 new ANC clients were tested for HIV in 2015 of which 398 were found to be HIV+. Of this number and those known to be HIV+ in the reporting year, 408 received ARVs for PMTCT. There were 139 live births by pregnant women who were HIV+, out of these 11 children tested within 18 months were found to be HIV+.