THE SAME-DAY test-and-start strategy is transforming HIV care, helping clients to begin treatment immediately and improving viral suppression rates.
Aligned with national guidelines, the approach ensures patients are quickly identified, counseled, and placed on treatment, reducing HIV-related complications.
“The same-day test-and-start approach involves identifying clients, counseling them, and commencing treatment immediately,” the Institute of Human Virology Nigeria’s ASPIRE Project Director, Dr. Idakwo, told National Record, adding that “this strategy has significantly reduced the mortality and morbidity associated with HIV.”
Clients receive antiretroviral drugs free of charge, making same-day treatment possible. “We closely monitor clients, follow them up, and provide treatment for opportunistic infections such as tuberculosis. For those diagnosed with TB, treatment begins immediately, and antiretroviral therapy starts after two weeks,” he added.
Dr. Idakwo emphasised that treatment does not end at initiation. “During the first 28 days, clients are closely monitored with follow-ups on days three, seven, 14, 21, and 28. We assess their concerns, check for adverse drug reactions, evaluate overall well-being, and identify any barriers to adherence.” The ASPIRE Project also adopts a client-centered approach. “Solutions are developed collaboratively with clients,” Dr. Idakwo explained, adding “Each individual is treated as a person, not just as part of a group.”
In addition, the project operates a “team-of-teams” model, combining facility-led and community-led teams, each guided by leaders. These cascade management teams work together to identify clients, retain them in care, and address challenges such as access to medication, stigma, or missed appointments. Continuous follow-up is a key part of the process.
Community collaboration is another pillar. Ward and Village Committees help spread awareness about HIV, encourage testing, and link individuals who test positive to care. Finally, the project works closely with the Supply Chain team to ensure uninterrupted medicine availability. “Clients access treatment at no cost, remain healthy, and continue on lifelong therapy that supports their long-term well-being,” Dr. Idakwo said.
With these strategies, Rivers State is not only improving HIV outcomes but also strengthening systems, empowering communities, and moving closer to epidemic control.
Supported by PEPFAR through the U.S. Centers for Disease Control and Prevention, the ASPIRE Project works across four Nigerian states to advance HIV epidemic control by strengthening laboratory systems, expanding prevention and treatment services, improving quality of care, and delivering comprehensive, community-based support.
Rivers State recorded the highest unmet need for HIV services in Nigeria according to the 2018 NAIIS. In response, a targeted intervention was launched in 2019 to expand treatment and prevention.
