GH22-2234: delivering comprehensive and sustainable HIV/aids clinical and community services to achieve HIV epidemic control in subnational units in nigeria under the president's emergency plan for…

GH22-2234: delivering comprehensive and sustainable HIV/aids clinical and community services to achieve HIV epidemic control in subnational units in nigeria under the president's emergency plan for aids relief (pepfar) - nigeria has an estimated 1,800,000 people living with HIV with over 80% of the adults already on antiretroviral treatment (art) as at the end of 2020. The country has made significant progress towards achievements of the unaids 95-95-95 goals with 90% of plhiv aware of their HIV status, 86% of HIV positives aware of their HIV status are on lifesaving art, while 72% of those on art have attained viral suppression. Despite these successes, critical gaps remain. The epidemic is characterized by wide spread disparities across states, LGA, and sub-populations. Pediatric treatment coverage remains low at 45%, the mother-to-child transmission rate is one of the highest in the world at 24.9%, key population (KP) continue to experience unequal access to prevention, treatment and care services, adolescent girls and young women (agyw) continue to face a higher risk of acquiring HIV. Urgent program priorities include expanding efficient case finding approaches among children and adolescents; optimizing and differentiating care for key populations (KP), scaling advanced HIV disease packages, and increasing quality of pediatric care and treatment and prevention of mother to child transmission of HIV (pmtct) services. Cihp nigeria: the centre for integrated health programs (cihp) is a multi-funded indigenous not-for-profit, non-governmental organization promoting better health outcomes for all nigerians through sustainable partnerships and locally adapted, rigorously tested approaches. Established in 2010, cihp has successfully managed multiple pepfar-funded HIV prevention, care and treatment and non-pepfar awards totaling over $270M. Currently cihp is the lead US government implementing partner for the president's emergency plan for aids relief grants and supports over 188,000 plwh on art in lagos, gombe, kaduna, and kogi states. Cihp delivers equitable, accountable, person center health interventions that are transparent and accessible to all, regardless of age, SEX or gender. Purpose and goals: the purpose of the 'innovate, recalibrate, integrate and surge to build resilient systems for sustained HIV epidemic control' ('iris') project is to leverage successes from cihp's current award, as well as other proven and innovative strategies for reaching the last mile among sub-populations, and communities at greatest risk of HIV acquisition, targeted case finding, accelerate art coverage, optimize viral suppression and achieve epidemic control in nigeria. To ensure no one is left behind cihp will structure its support and activities around 4 project goals: (1) strengthen HIV prevention programs including HIV case finding among pediatrics; focused KP and pmtct services, (2) sustain the gains of the art scale up in the last 2 years by ensuring that clients continue in treatment and virally suppressed, (3) support cross-cutting, systems-level interventions such as improved laboratory services, quality, covid-19 service integration, timely data for program planning and decision-making and (4) collaborate with GON and the CSO to foster sustainability and program ownership. Outcomes: by 2027, cihp will support the government of nigeria (GON) to ensure >95% of estimated plhiv are aware of their status, achieve art saturation and durable viral suppression among all populations and age/SEX bands in lagos, gombe, kaduna, kogi and ogun states. Using a combination of data driven, proven, innovative and differentiated approaches that span health facility and community settings. Cihp will initiate an estimated 81,566 plhiv on art (10-15% pediatrics) and maintain a projected 299,863 patients with a