Nigeria is intensifying efforts to eliminate AIDS as a public health threat by 2030. Until recently, HIV prevention in the country relied largely on daily oral pre-exposure prophylaxis (PrEP), but adherence challenges, stigma, limited awareness, and inconsistent access have hindered widespread uptake. The introduction of long-acting injectable PrEP, which can last two to six months, is expected to expand access, offer more prevention choices, and help bridge gaps in coverage, supporting both national and global HIV objectives.
With technical support from the World Health Organization (WHO) and funding from the Global Fund, Nigeria’s National AIDS, Viral Hepatitis and STIs Control Programme (NASCP), alongside the National Agency for the Control of AIDS (NACA) and implementing partners, conducted a landscape and site-readiness assessment across over 70 public health facilities in 10 states. This review examined delivery platforms, assessed readiness for multiple PrEP options, and provided evidence to guide national planning. Dr. Bashorun, NASCP Coordinator, emphasized that the assessment offers insights for integrating injectable PrEP into public health services to ensure HIV prevention tools reach diverse populations.
The injectable PrEP option addresses challenges associated with daily oral use, including pill fatigue and adherence difficulties. Individuals at high risk, such as those in serodiscordant relationships, people with multiple sexual partners, pregnant or breastfeeding women at high risk, and key populations like sex workers and men who have sex with men, stand to benefit significantly. By providing an alternative to daily pills, injectable PrEP offers more convenient and effective protection for those who struggle with adherence.
The 10-state assessment also examined critical service components, including availability, screening, supply chain, health worker capacity, and data management, to identify barriers and enablers for equitable access. Findings will guide the phased introduction of injectable PrEP and its integration into broader health service platforms, including antenatal clinics, family planning units, and community outreach programs. Dr. Bashorun highlighted that client-centered and accessible services are essential to closing prevention gaps.
WHO continues to support Nigeria by providing technical assistance, capacity-building, policy development, and integration of PrEP into sexual and reproductive health services. Guidance on national protocols and monitoring systems ensures a safe, effective, and equitable roll-out. Dr. Oluwafunke Odunlade, WHO HIV Technical Officer in Nigeria, noted that embedding PrEP into existing health services strengthens the health system while reaching people where they already seek care, fostering sustainability and wider HIV prevention coverage.
