A community-led effort

According to Dr. Emilio Dirlikov, lead author of the study and Acting HIV Program Director for CDC-Nigeria in early 2022, engagement with local communities – particularly community health care workers – was another critical linchpin.

CDC and partners both trained and were guided by local community health workers who helped lead the day-to-day program operations. This approach, says Dr. Dirlikov, allowed the effort to “get real data, reach real people, and achieve real results.” In several states, for example, community health workers were able to engage first with community leaders and impress upon them the critical importance of HIV testing as well as other health screenings that were integrated into the Surge outreach efforts. The leaders, in turn, would send town criers throughout the community, alerting members to the screenings offered by CDC and the Ministry of Health. Consequently, the program was able to engage large crowds of community members to come forward for HIV testing and other health screenings as well.

Davis Akuye is one of the community health workers who helped support the 18-month Nigeria HIV treatment Surge. A resident of Rivers state, he has seen first-hand the devastation that HIV has brought to his community. “Part of my reason for doing this work is because I have seen people becoming ill from this virus, and I have seen the deaths and those that are left behind. For me, this is a way that I can give back, that I can help restore healing to my own community,” he said.

As part of his job, Davis goes door to door, paying daily visits to community members in their homes, providing information, HIV testing, and when necessary linking his fellow community members to HIV treatment services provided at the local health facilities. He recalls one particular incident where he was able to make a powerful impact.

“There was one client whose girlfriend tested positive for HIV,” he recalls. “He was very upset and very afraid to get tested because he thought he had also contracted the virus,” he said. “Because we are from the same community, with the same language and the same understandings, I could help him understand the importance of getting tested.” Ultimately the client learned he was HIV negative and at Davis’ urging began taking pre-exposure prophylaxis, or PrEP, to protect himself from the virus. At the same time, the client’s girlfriend was initiated on HIV treatment. “Today, they are a happy, healthy married couple,” he says proudly.