INTERVIEW: Why new HIV survey is crucial to Nigeria

The Nigeria Aids Indicator and Impact Survey (NAIIS) is a nationwide exercise to establish the prevalence of HIV/AIDS and also determine the distribution of Hepatitis B & C in the country.

The survey, to which the United States government donated $90 million, is the 12th of its kind in the world and the largest to be conducted on HIV. It will hold from June to December this year.

In this Interview with PREMIUM TIMES’ Nike Adebowale, Mukhtar Muhammed, the Senior Technical Adviser to the Director-General of the National Agency for the Control of Aids (NACA) and project manager of the survey, gives an overview of the survey.

PT: What is the survey all about?

Muhammed: The National Agency for the Control of Aids (NACA), in collaboration with the Federal Ministry of Health and other stakeholders, most especially the US President Emergency Plan for Aids Relief (PEPFAR), is implementing this large household survey. The survey is going to determine the prevalence of HIV/AIDS, which will help us determine the burden of the epidemic. It will tell us where the new infections are happening and it will tell us the impacts of all the services that have been provided so far in the country. It is a survey that has not been conducted in Nigeria before.

We are making it elaborate because we really want to get down to the lowest level, which is the states and the local governments. For the first, we will have state prevalence estimate, and that will guide us in programming in the states.

It will tell us the focal of the epidemic, where new infections are, so that we can plan and address those issues. It is also going to tell us how far those people on treatment have gone and their well-being, to know if the drugs are working and if there is virus suppression. If there is no virus suppression, we need to know what is happening.

It is different from previous surveys because all we have gathered in previous surveys is national estimates. In this survey, about 170,000 persons will be tested.

PT: What strategy is being put in place to ensure people cooperate in the survey?

Muhammed: Like I said earlier, this survey will cover about 170,000 persons. Every state and local government will be reached in this survey. Within this local government, we have selected certain clusters which is based on a scientific method, which will serve as representative samples. Adults and children will be tested in this survey.

One of the strategies we have put in place is that we want country ownership. The survey has to be conducted in Nigeria, by Nigerians, with the involvement of all the stakeholders in the country. We want to make sure that Nigerians are trained on how to administer the questionnaires, collect the samples and also do the testing.

So far, we have trained 1,300 people from various states who are going to be our field workers for the survey. We have designated about 111 laboratories where testing will be done. The laboratories are located in various states, so in each state we have about three laboratories. We will do some testing in the households, while some will go to these laboratories and some test will have to come to the central laboratory here in Abuja. These are some of the strategies on ground.

We are going to do the survey in six phases. We have already started the pilot for the survey and it is taking place in about 12 states. It is going to take place for about five days. We will review the pilot to make any changes necessary. The pilot covers the training and mobilisation of field workers.

PT: What is your team doing to ensure adequate awareness before the commencement of the survey?

Muhammed: We are working with our media and communications team for this survey. We are keeping the press aware of all the procedures. And the press in turn, are giving the information to the public. The Minister of Health and the Director-General of NACA recently signed an MOU with our global partners, of which some of the pressmen were present. We have series of programme that are going on air on television, radio etc. We have jingles and messages on the survey that will be aired all over the country in the various radio and television stations. The print and online media are also spreading facts about the survey.

So we have an elaborate plan, of which we have started some.

The survey is not going to be conducted at once, we are taking six states at a time. In each zone, we are taking six states, we will do it and finish. Then we will take another six states and finish, so we will do that six times to cover all states. So that is why it will take us six months to finish the survey.

Apart from that, we are also engaging the stakeholders at the state level for advocacy. All the state governments and other stakeholders, religious institutions are all engaged. We are engaging the National Orientation Agency at the state level to help with the community mobilisation. We also have our community entrust plan where each community we are going to, we go through the channels like traditional rulers, village heads until we reach the heads of the households.

So that is the communication plan. We are going to make it more elaborate and implement more.

PT: How much has been spent so far on this survey?

Muhammed: The survey is a joint effort between the federal government and PEPFAR. The spending on logistics, equipment and the rest is done by the United States government. So I do not have figure of how much have been spent. But we have discussed everything, it is a work plan and it is been implemented.

The United States government keeps the money, but they have an implementing partner which is the University of Maryland. It is a university in the US but they have a project office in Nigeria. So they are the one that manages the funds. They are the ones that paid for the trainings, bought the equipment and other spending.

PT: What plans have you put in place to ensure that people, especially those living in rural areas cooperate with the field workers?

Muhammed: One of the things we do, which we call the ethics for this survey is that nobody will be forced to participate in the survey, it is voluntary. However, we have counsellors who will inform the people correctly about the information on the survey. These counsellors are trained, we have also retrained them and they are going to talk to every head of households and members of the households about the need for them to allow their blood to be taken for the survey. They are professionals so we are sure to some extent that a lot of people will agree and participate.

Look at the benefits, the counsellors are going to tell them about the benefits of the survey. They will inform them that if they have HIV or Hepatitis, they are going to be linked to free treatment immediately. And if you don’t have HIV, we will reinforce messages to you about the ways to prevent yourself and your love ones from getting HIV.