Poor Compliance to HIV/AIDS Treatment Frustrates Efforts Towards Virus Elimination By 2030 – NIMR Boss

EKOHOTBLOG gathered that the World Health Organization (WHO) is in support of SDG Target 3.3, which aims to end the epidemics of AIDS, tuberculosis, malaria, and other communicable diseases by 2030.

This target focuses on reducing new HIV infections, decreasing AIDS-related deaths, and eliminating discrimination against people living with HIV. 

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The WHO and its partners work to achieve these goals through prevention, testing, treatment, and creating a supportive environment.

It was against this background that the Nigerian Institute of Medical Research (NIMR) embarked on a series of research projects.

On Wednesday, August 27, 2025, NIMR’s DG, Prof. Obafunwa, hosted Ekohotblog and other media organisation to discuss their research findings.

Dr. Agatha David, a research fellow and director of research at NIMR who specializes in providing clinical care to children and young adults, revealed the scope, aim, and outcome of the research.

The research was focused on assessing the Health and Well-being of Adolescents and Young Adults Living with HIV.

Below is a summary breakdown of the research presentation:

Who is Dr. Agatha David?

• Role and focus: Dr. Agatha David serves as Director of Research and a Consultant Pediatrician at NIMR. She also coordinates the Institute’s Child and Adolescent HIV Program.
• Experience and impact: With more than two decades of professional and clinical engagements in child and adolescent health, her work centers on infectious diseases and nutrition. Notably, she established Nigeria’s first adolescent and youth HIV support group and clinic for Adolescents and Young People Living with HIV (AYLHIV), as well as an outreach HIV clinic at the Sisters of Charity Orphanage in Lagos.
• Current research: Her focus now lies in AYLHIV health, emphasizing Antiretroviral Therapy (ART) adherence, Sexual and Reproductive Health (SRH), and Mental Health (MH).

Key Takeaways from the Media Chat

1) The Challenge: Adolescents and Young people Living with HIV (AYLHIV) Lag Behind in HIV Elimination SDG Targets

• AYLHIV in Nigeria experience the poorest treatment outcomes among all age groups.
• They are not on track to meet the UNAIDS 95-95-95 goals for 2025, jeopardizing progress toward the United Nation’s SDG 3 (ending the HIV epidemic by 2030).
• The three objectives of the 2030 SDG target at risk:
  • 95% of people living with HIV knowing their status
  • 95% of those who know their status should be on life-saving antiretroviral therapy (ART)
  • 95% of those on ART virally suppressed

2) HIV Testing, Linkage to Care, and Pre-Exposure Prophylaxis (PrEP) Uptake

• Testing gaps: About 40% of new HIV infections occur in AYLHIV, yet testing rates in this group are alarmingly low (around 23.7% in recent data).
• Innovative responses:
  • Peer navigators using mobile health and social media (e.g., WhatsApp) to educate and encourage testing.
  • Outreach testing: offering free HIV tests at convenient locations (homes, workplaces, neighborhoods).
  • Comprehensive counselling: pretest and post-test, with rapid linkage to care for positives.
• Results (2022–2023):
  • ~1,000 AYA tested, with ~120 (12%) testing positive and linked to care and ART.
  • HIV-negative individuals were offered free Pre-Exposure Prophylaxis (PrEP); uptake was under 10%.

3) ART Adherence and Viral Suppression Among Adolescents and Young People (AYA)

• Importance: Adherence to ART is critical for viral suppression, preventing resistance, reducing transmission, and improving quality of life.
• Challenges: Adolescent development, stigma, discrimination, and treatment fatigue compromise adherence.
• Interventions and findings:
  • Directly Observed Antiretroviral Therapy (DOART): Caregiver-supported dosing reduced apparent drug resistance and improved suppression in cases previously deemed resistant.
  • SMS reminders: One-way reminders helped, but bi-directional reminders (two-way communication confirming dose intake) were more effective.
  • Peer navigation plus bi-directional reminders: Synergistic support increased adherence and improved viral suppression to below 1,000 copies/mL. Still aiming for suppression below 50 copies/mL.

4) Other Challenges Facing AYLHIV

• Mental Health: Studies show high rates of anxiety, depression, and suicidal ideation among AYLHIV. A study on integrating mental health counselling into routine AYLHIV care is in development.
• Sexual and Reproductive Health (SRH):
  • Lagos-focused SRH research revealed gaps: poor SRH knowledge, risky sexual behavior, under-resourced adolescent-friendly services, and insufficient sexuality education.
  • Highlights the need for comprehensive SRH advocacy, education, stronger parental involvement, economic support, and accessible SRH services for AYLHIV.

Why This Matters

• The NIMR briefing paints a clear picture of progress in combating HIV in younger populations, which requires a multi-pronged approach—enhanced testing, rapid linkage to care, pragmatic ART adherence strategies, and robust mental health and SRH support.
• Dr. David’s team has demonstrated concrete interventions with tangible early successes (e.g., DOART, SMS-based strategies, peer navigation). These approaches could inform broader national strategies and potential replication in other regions.

NIMR’s Future Plans

• The Institute is exploring intensified mental health interventions and expanded SRH programming to address gaps identified in Lagos and beyond.
• Future initiatives may include scaling up community-based testing, expanding Pre-exposure Prophylaxis (PrEP) advocacy, education, and access, and integrating family and caregiver engagement into adherence programs.

What This Means for the Nigerian Public

• For young people living with HIV, the message is twofold: access to supportive services is improving, and adherence support is becoming more tailored and accessible.
• For families, communities, and policymakers, the work at NIMR underscores the essential need to normalize testing, treat stigma as a barrier to care, and invest in youth-friendly health services.

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