Evidence from epidemic appraisals in Nigeria

Despite efforts to address the epidemic, effective programming has been hindered by a lack of information on strategies that maximize coverage and cost-effectiveness. To address this gap, epidemic appraisals (EAs) were conducted in eight states to provide evidence for the planning, implementation, and coordination of prevention interventions. The EAs involved three components: mapping, venue profiling, and rural appraisals. Mapping determined the size, typology, and locations of MARPs, while venue profiling identified and profiled venues where general populations engaged in high-risk behaviors. Rural appraisals provided insights into risk behaviors and sexual networking in villages. The results of the EAs were used to prioritize areas with a MARP coverage of 70-80% and to scale up interventions for non-brothel-based FSWs instead of focusing on brothel-based FSWs. The EAs also identified high-risk general populations and provided evidence for focusing interventions on these populations. The results showed that six states implemented interventions at bars and night clubs, previously not covered, and maximized intervention coverage for high-risk general populations. The EAs also led to cost efficiencies, as resources were focused on high-coverage areas rather than being spread across entire states. The EAs were adapted from a methodology used in India, which involved assessing other high-risk networks in the general population. The results of the EAs were used to plan and target HIV prevention programs in eight Nigerian states, with a focus on four objectives: to describe how the findings from the EAs could form the framework for planning, implementing, and coordinating MARP interventions; to demonstrate the pivotal nature of the EA results to MARP prevention programming; to show how the EA-generated evidence is being used by all stakeholders in Nigeria for allocating resources efficiently and prioritizing target populations; and to illustrate how EAs can be used to achieve optimal coverage of prevention services for the high-risk general population. The use of EAs to conduct geographic mapping of key populations was first done in India, where the results were used to plan service delivery at the local government area (LGA) level and to prioritize resource allocations. The EAs have been adapted for use in other countries, including Nigeria, where they have been used to inform HIV prevention programming. The results of the EAs have been used to identify high-risk areas and populations, and to inform the allocation of resources for HIV prevention programs. The HIV epidemic in Nigeria is characterized by high prevalence rates among MARPs, and effective programming has been hindered by a lack of information on strategies that maximize coverage and cost-effectiveness. The EAs have provided evidence for the planning, implementation, and coordination of prevention interventions, and have been used to inform HIV prevention programming in eight Nigerian states. The results of the EAs have been used to identify high-risk areas and populations, and to inform the allocation of resources for HIV prevention programs. The EAs have also been used to demonstrate the pivotal nature of the EA results to MARP prevention programming, and to show how the EA-generated evidence is being used by all stakeholders in Nigeria for allocating resources efficiently and prioritizing target populations. The EAs have been adapted from a methodology used in India, which involved assessing other high-risk networks in the general population. The results of the EAs have been used to plan and target HIV prevention programs in eight Nigerian states, with a focus on four objectives. The use of EAs to conduct geographic mapping of key populations has been shown to be an effective tool for informing HIV prevention programming. The EAs have been used to identify high-risk areas and populations, and to inform the allocation of resources for HIV prevention programs. The results of the EAs have been used to demonstrate the pivotal nature of the EA results to MARP prevention programming, and to show how the EA-generated evidence is being used by all stakeholders in Nigeria for allocating resources efficiently and prioritizing target populations.