Dynamics of The Universal Test and Treat Strategy in HIV Patients in Nigeria: A Narrative Review of Studies

HIV and AIDS infection are major public health problems in sub-Saharan Africa. HIV is spread through contact with certain body fluids from a person with HIV, such body fluids include; blood, semen, pre-seminal fluid, vaginal fluids, rectal fluids, and breast milk. HIV attacks and destroys the CD4 cells. Antiretroviral Therapy (ART) is recommended for everyone who has HIV. ART prevents the HIV from multiplying and reduces the amount of HIV and viral load to an undetectable level in the body. According to the latest HIV treatment Guideline Nigeria published in 2016, it says; ART should be initiated in all adults, adolescents, pregnant and breastfeeding women, and children with a diagnosis of HIV regardless of WHO clinical stage and regardless of CD4+ cell count. Initiating ART treatment as soon as possible after HIV infection has been demonstrated to reduce viral load, decrease transmission and possibly reduce rates of loss to follow-up (LTFU) patients. This study assessed the attributes and outcomes of the universal test and treat strategy in HIV patients in Nigeria. This study reviewed the overview of HIV patients in Nigeria after the implementation of the Universal test and treat strategy initiated in 2016 with the use of a narrative style of literature review. This study reviewed literature retrieved from searches of computerized databases. The studies selected included those written in the English Language that was carried out in Nigeria with a clear study design and properly stated year of publication which fell within the stated years of 2016 to 2021. A total of 17 articles met the study criteria and were used for the study. South-west (29.41%) had the highest distribution of articles on HIV test and treat strategy done in Nigeria. This was followed by South-south with a distribution of (17.65%). North-west, North-central, South-west and Nationwide had an equal distribution of (11.76%). North-east had the smallest number of studies done so far in Nigeria with (5.88%). Most of the studies were conducted between 2011- 2020 and three articles were published in 2021 (17.65%). The articles cited in this study are those of HIV patients of major population groups who are receiving ART care with the new treatment guidelines in Nigeria. The distribution of the studies conducted on the HIV test and treat strategy was more in the South-west region of Nigeria than in other geopolitical regions.

Keywords:Universal test and treat strategy; HIV infection; Nigeria; Antiretroviral

Abbreviations:HIV: Human Immunodeficiency Virus; AIDS: Acquired Immune Deficiency Syndrome; ART: Anti-retroviral Therapy; UTT: Universal test and treat; LTFU: Lost to follow up; PLHIV: People Living with HIV