Asian Journal of Research in Medical and Pharmaceutical Sciences

Background: Achieving optimal retention in HIV care among children living with HIV (CLHIV), Adolescent and young people (15-24years) Caregivers and general population remains a significant challenge in Nigeria, limiting progress toward the 95–95–95 targets of UNAIDS. Gaps in HIV case finding among children and adolescents, linkage to treatment, and sustained engagement in care continue to affect treatment outcomes. This study assessed the outcomes of a community-based intervention designed to improve HIV case identification, linkage to care, retention, and viral suppression among children and their caregivers in selected communities in Taraba State, Nigeria.

Methods: A community-based program was implemented across three Local Government Areas (LGAs) Karim Lamido, Sardauna, and Ussa to identify undiagnosed HIV cases among children and their caregivers and support them to remain in care and ultimately achieve viral load suppression. The intervention used targeted screening, home-based HIV testing, community outreach, and promotion of HIV self-testing to increase uptake and reduce stigma. Children, adolescents, caregivers and some general population diagnosed with HIV were linked to treatment and supported through differentiated service delivery models, including community pharmacy-based antiretroviral distribution, community antiretroviral treatment support, nurse-led community clinics, and integrated mental wellness services. Capacity-building activities were conducted for multi-disciplinary healthcare workers, case managers, community volunteers and people with lived experienceto promote stigma-free and patient-centered care. Programmatic data collected over a one-year post implementation period were analyzed to assess outcomes across the HIV care cascade: testing and case finding (first 95), linkage and retention in care (second 95), and viral suppression (third 95).

Results: A total of 8,990 Children, adolescents, caregivers and general populations were tested for HIV across the three LGAs, with nearly equal representation of males (49.5%) and females (50.5%). Overall, 233 Children, adolescents, caregivers and general populations tested HIV-positive, yielding a positivity rate of 2.6%, with females accounting for 69.5% of positive cases. Children aged 0–14 years constituted the largest group tested (2,675) but had the lowest positivity rate (0.8%), while higher positivity rates were observed among caregivers (4.7%) and the general population (4.5%). Of the 233 Children, adolescents, caregivers and general populations who tested positive, 168 were referred for treatment and 163 were successfully linked and enrolled in HIV treatment services, resulting in a linkage rate of 97%. The remaining 65 were known HIV cases that were on treatment. Among those linked, 143 (14 children, 32 adolescents and young people, 42 care givers and 55 general population) remained actively engaged in treatment, corresponding to an overall retention rate of 88%. Retention varied across LGAs, with Karim Lamido recording the highest retention (95%), followed by Ussa (81%) and Sardauna (73%). Among Children, adolescents, caregivers and general populations on antiretroviral therapy, 91 had valid viral load results, and 88 achieved viral suppression, corresponding to a suppression rate of 97%.

Conclusion: The intervention demonstrated strong performance across the HIV care cascade, with high linkage to care, substantial retention, and excellent viral suppression outcomes among children, caregivers, and community members. Community-based case finding combined with differentiated service delivery and integrated psychosocial support can significantly improve HIV treatment outcomes in resource-limited settings. Scaling up such approaches may help close retention gaps and accelerate progress toward HIV epidemic control in Nigeria.