Cooperative Agreement NU2GGH002417

ACTION TO SUSTAIN PRECISION AND INTEGRATED HIV-RESPONSE TOWARDS EPIDEMIC CONTROL (ASPIRE) PROJECT - INSTITUTE OF HUMAN VIROLOGY NIGERIA (IHVN), A QUALIFIED LOCAL PARTNER, ENGAGED IN PEPFAR IMPLEMENTATION SINCE 2004, PROPOSES THE ASPIRE PROJECT (ACTION TO SUSTAIN PRECISION AND INTEGRATED HIV RESPONSE TOWARDS EPIDEMIC CONTROL) IN PARTNERSHIP WITH SCIDAR (SUPPORTING PRIVATE HEALTHCARE SECTOR LINKAGE) EHAI (SUPPORTING EQUITY IN HEALTH SYSTEMS STRENGTHENING) AND UNIVERSITY OF MARYLAND BALTIMORE (SUPPORTING HEALTH INFORMATICS, LABORATORY STRENGTHENING, AND QUALITY IMPROVEMENT). ASPIRE BUILDS UPON IHVN'S FOUNDATION OF ITS 360 COMPREHENSIVE ART SITES EVIDENCED BY THE 340,127 PLHIV SUSTAINED ON DURABLE ART, OUR 99.4% LINKAGE TO ART, AND 95.4% WITH VIRAL LOAD SUPPRESSION (VLS) WITH AN INTERRUPTION IN TREATMENT RATE OF 1.1% UNDER ITS CURRENT ACHIEVE PROJECT AWARD. LESSONS LEARNED THROUGH THE RIVERS STATE "SURGE" IMPLEMENTATION WHERE TX_CURR WAS SCALED EXPONENTIALLY FROM 21,00 TO 173,392 TO ACHIEVE 90% TREATMENT SATURATION OVER 18 MONTHS WILL BE AMPLIFIED AND REFINED TO ACHIEVE THE PURPOSE OF ASPIRE. SIMILARLY, FEDERAL CAPITAL TERRITORY, DELTA, AND NASARAWA STATES HAVE ACHIEVED SATURATION >95 WHILE KATSINA STATE IS PROGRESSING TOWARDS SATURATION WITH 34.5% OF ITS ANNUAL TARGET ACHIEVED IN QUARTER 1 FY22. IHVN IS FOCUSED ON THE TRANSITION OF HIV PROGRAM OWNERSHIP TO THE GOVERNMENT OF NIGERIA. ASPIRE'S APPROACH IS UNDERPINNED BY: 1) PEOPLE-CENTERED SERVICES WHERE CLIENTS' ARE VALUED AS EQUAL PARTNERS WHO ARE SERVED BY INTEGRATED AND CLIENT-CENTRIC DIFFERENTIATED SERVICE DELIVERY (DSD) APPROACHES; 2) COMMUNITY ENGAGEMENT THAT TARGETS UNDERSERVED COMMUNITIES, KEY POPULATIONS (KP), AND PRIORITY POPULATION (PP) AT THE HIGHEST RISK AND THEIR ENGAGEMENT AS PARTNERS IN THE DESIGN, IMPLEMENTATION, AND EVALUATION FOR NON-STIGMATIZED SERVICE PROVISION. 3) RESILIENT AND ADAPTIVE APPROACHES INFORMED BY EXPERIENCE AND DATA THAT GUIDED PROGRAM IMPLEMENTATION IN THE FACE OF THE COVID EPIDEMIC THAT FURTHER STRESSED NIGERIA'S FRAGILE HEALTH CARE SYSTEM. 4) SUSTAINABLE TRANSFORMATION ACHIEVED THROUGH PARTNERSHIP WITH GON AND CSOS/CBO WHO ASSUME OWNERSHIP OF ACCOUNTABLE AND EVIDENCE-BASED SERVICES ENHANCED BY CONTINUOUS QUALITY IMPROVEMENT. ASPIRE EMBRACES 6 STRATEGIES: 1) IMPLEMENT A MIXED MODEL OF EFFICIENT HIV TESTING AND LINKAGE IN FACILITIES AND COMMUNITIES TO IDENTIFY AND LINK PLHIV: 2) IMPLEMENT TESTED, INNOVATIVE, AND CLIENT-CENTRIC INTERVENTIONS FOR OPTIMAL PLHIV TREATMENT CONTINUITY, MANAGEMENT OF ADVANCED HIV DISEASE, AND DURABLE VIRAL SUPPRESSION: 3) PREVENT NEW HIV INFECTIONS THROUGH EVIDENCE-BASED INTERVENTIONS AT FACILITY AND COMMUNITY LEVELS: 4) PROVIDE RELIABLE, HIGH QUALITY AND TIMELY LABORATORY SERVICES FOR DIAGNOSIS, CONTROL, PREVENTION, AND MONITORING OF HIV AND OTHER DISEASES: 5) IMPLEMENT QUALITY IMPROVEMENT APPROACHES AT PATIENT, FACILITY AND COMMUNITY LEVELS TO TRACK AND OPTIMIZE HEALTH OUTCOMES: 6) DEVELOP AND IMPLEMENT A SUSTAINABILITY PLAN TO INCREASE GON'S LEADERSHIP, GOVERNANCE, AND INVESTMENT IN HIV PROGRAMS. TO ACHIEVE PROGRAM OUTCOMES WITH EFFICIENCY AND PRECISION IHVN DEPLOYS GRANULAR SITE MANAGEMENT GUIDED BY INTEGRATED ELECTRONIC MEDICAL RECORDS (EMR), MONITORED BY REAL-TIME DATA DASHBOARDS TO SUPPORT CONTINUOUS QUALITY IMPROVEMENT (CQI). OUTCOMES OF CQI SUCCESSES ARE SHARED THROUGH VIRTUAL COMMUNICATION-SUPPORTED LEARNING NETWORKS. BASED ON THESE EVALUATIONS CLIENT CENTER APPROACHES ARE IMPLEMENTED AND RESOURCES TARGETED THROUGH APPROACHES SUCH AS GEOGRAPHIC LOCALIZATION FOR IMPACT USING SMALL AREA ESTIMATION/MAPPING. IHVN ENGAGES THE PEPFAR INFRASTRUCTURE TO PROMOTE COVID MITIGATION STRATEGIES. INTEGRATION OF HIV SERVICES INTO THE MAINSTREAM OF HEALTH CARE AS PART OF THE GON TRANSITION PLAN INCLUDES SEAMLESS COORDINATION OF HIV, TB, WOMEN'S HEALTH, AND KP SERVICE DELIVERY. OUTCOMES OF ASPIRE, GUIDED BY PEPFAR EPIDEMIC CONTROL METRICS ARE: 1) REDUCED MORTALITY BY PLHIV KNOWING THEIR HIV STATUS AND BEING LINKED TO QUALITY S