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There are missed opportunities for the prevention of mother-to-child transmission of HIV (PMTCT) in Nigeria. However, little is known about the geographic variation. We examined the geographic pattern in the missed opportunities for HIV testing among antenatal care (ANC) attendees and initiation t on antiretroviral therapy (ART) in Nigeria. This study was an analysis of aggregated state-level data on 2,875,370 ANC attendees from the 2019 national HIV/AIDS health sector data. We performed descriptive statistics and explanatory spatial data analysis. Overall, the missed opportunity for HIV testing was 9.3%, ranging from 1.8% in the South South to 14.5% in the North West. The missed opportunity for HIV testing ranged from 0.2% in Imo State to 25.2% in Kaduna State. The local indicator of spatial association cluster map showed a concentration of cold spots in the South and hot spots in the North. The overall missed opportunity for ART was 9.5%, ranging from 7.4% in the South West to 11.1% in the NorthCentral. It was lowest in Adamawa State (0%), while Enugu State had the highest (32.2%). Missed opportunities for PMTCT among women attending ANC in Nigeria occur at varying degrees across the states, with higher levels in the northern region.

Antiretroviral (ARV) drugs are effective in the prevention of mother-to-child transmission of HIV (PMTCT), however many sub-Saharan African countries are yet to achieve universal ARV coverage among pregnant women living with HIV. This study examined factors associated with ARV coverage for PMTCT in 41 sub-Saharan Africa countries. Country-level aggregated data were obtained from the Joint United Nations Programme on HIV/AIDS, World Health Organization, and United Nations Children's Fund. Using Spearman's rho and point-biserial correlation, we conducted bivariate analyses between ARV coverage for PMTCT and the following variables: stigma, antenatal care (ANC) uptake, institutional delivery, community delivery of ARV drugs, number of HIV testing and counselling (HTC) facilities, and density of skilled health workers. We also performed a multivariate median regression with the significant correlates.

HIV/AIDS remains a major public health problem despite the efforts to prevent and decrease its spread. Sub-Saharan Africa (SSA) represents 70% of the global number of people living with HIV and 73% of all HIV/AIDS-related deaths. Young adults age 15-24 years are disproportionately impacted by HIV/AIDS in SSA with 34% of people living with HIV (PLWHIV) and 37% of newly diagnosed individuals being in this age group. It is important that PLWHIV be linked to care to facilitate antiretroviral therapy (ART) initiation and limit the spread of infection. We conducted a systematic literature review to identify effective interventions designed to improve linkage to care among HIV-infected young adults in SSA. One hundred and forty-six titles and abstracts were screened, 28 full-texts were reviewed, and 6 articles met the inclusion and exclusion criteria. Home-based HIV counseling and testing, home-based HIV self-testing, and mobile HIV counseling and testing followed by proper referral of HIV-positive patients to HIV care were effective for improving linkage of young adults to care. Other factors such as referral forms, transportation allowance, home initiation of HIV care, and volunteer escort to the HIV treatment clinic were effective in reducing time to linkage to care. There is a vast need for research and interventions that target HIV-positive young adults in SSA which aim to improve their linkage and access to HIV care. The results of this study illustrate effective interventions in improving linkage to care and reducing time to linkage to care of young adults in SSA.

Young people 15–24 years old represent 39% of new HIV infections globally. However, they are the least likely age demographic to seek HIV testing and the most likely to be unaware of their HIV status. The purpose of this systematic literature review was to identify interventions that increase either rates of HIV testing or intentions to seek HIV testing in young people 10–24 years old. In total, 1601 manuscripts were systematically examined and five manuscripts were included in the final review. Two common themes identified in the interventions were education and test delivery methods. Educational programs were found to be effective when delivered in classroom or entertainment-based formats. Health providers offering testing and home testing increased the rate of testing. Additional research is needed on programs aimed at young people not enrolled in schools, interventions that measure testing rates, and educating healthcare providers about offering HIV tests to young people.

Although improved knowledge is often the first approach in HIV prevention for adolescents, studies have shown that despite being well informed, adolescents still engage in risky sexual behavior (RSB). Low self-esteem has been considered to be a psychological explanation for behavioral problems, but little is known about the impact of self-esteem on RSB among adolescents in Nigeria. The purpose of this study was to determine whether adolescents with high self-esteem demonstrate lower RSB compared to those with low self-esteem. We conducted a cross-sectional survey of 361 adolescents in 9 secondary schools in Jos Plateau, Nigeria. The Rosenberg Self Esteem Scale was used to measure self-esteem and the Brief HIV Screener (BHS) was used to measure RSB. All data were analyzed using SPSS 21. Chi square and odds ratios were calculated to determine differences in BHS questions based on predetermined low or high self-esteem categories. Independent t-test were utilized to determine difference in mean BHS scores based on self-esteem categories. Participants were 169 male (46.8%) and 192 female (53.2%) with a mean age of 16.9. Mean self-esteem score was 27.6 with no significant difference in self-esteem scores by gender. Adolescents with low self-esteem were 1.7 times more likely to be sexually active and had a higher mean BHS scores compared to adolescents with high self-esteem. Programs aimed at reducing RSB and in-turn HIV/AIDS should consider interventions to raise adolescents' self-esteem.

Current guidelines recommend annual Papanicolaou (Pap) smears for human immunodeficiency virus (HIV)-infected women for cervical cancer screening. Rates for such screening in Nevada are below the national rate. Our cohort includes 485 eligible HIV-infected adult women from an outpatient center in Southern Nevada of which only 12 women had obtained a Pap smear in the past year. An intervention was conducted from June 2015 to September 2015, in which reminders to schedule a Pap smear were sent to the remaining cohort of 473 women via sequential text messaging, followed by phone call attempts. Of all subjects, 94% contacted by text messages and 41% contacted by phone calls were successfully reached. There was an increase in the rate of completed Pap smears from 2.5% (12/485) at baseline to 11.8% (56/473) after interventions (p 0.0001) in a period of three months. Out of the 68 Pap smear results, 20 (29.4%) were abnormal. Our intervention, utilizing methods of communication such as text messaging and phone calls, markedly increased the rate of completed Pap smear screening in our population.