DOI: 10.7910/dvn/kzkq6k
title: Nigeria (2013 )Research Protocol for Qualitative Study on Most At Risk Population (MSM and DIU)

description: HIV/AIDS is a global crisis with Nigeria ranked second in the number of people living with HIV/AIDS after South Africa. Nigeria currently has prevalence of 3.4% among men and women of reproductive age (15 – 49 years), representing more than three million people living with HIV. However, HIV prevalence in Nigeria is highly variable, with wide differences in vulnerability found both geographically and by population. Antenatal data by state shows a range in HIV prevalence from a high of 12.7% in Benue to a low of 1.0% in Kebbi. Similarly, across the country, the urban prevalence of HIV was found to be higher than the rural prevalence in all the states and FCT, with the exception of eight states in five zones. A mode of HIV transmission study conducted by the government of Nigeria in 2009 found that high risk populations (female sex workers (FSWs), men who have sex with men (MSM) and persons who inject drugs (PWIDs)) account for 23% of new infections, though they comprise only 1% of the population. Findings from the recent Integrated Biological and Behavioural Surveillance Survey (IBBSS) conducted by the Federal Ministry of Health (FMoH) in 2010 revealed HIV prevalence of 27.4% among brothel-based FSWs, 21.7% among non-brothel-based FSWs, 17.2% among MSM and 4.2% among PWIDs. The Strengthening HIV prevention Services (SHiPS) for MARPs implemented by a consortium led by the Society for Family Health (SFH) is a five year project aimed at strengthening HIV prevention activi
ties among the Most-at-Risk Populations (MARPs). The goal of the project is to improve the health of people in Nigeria by reducing the prevalence of HIV among those most at risk and vulnerable to HIV. To achieve this goal, the SHiPS’ consortium partners will strengthen HIV prevention services for most-at-risk populations (MARPs), especially for female sex workers (FSWs) and their clients through four objectives: • Increased organizational capacity of local stakeholders to develop, manage and evaluate effective HIV prevention interventions and create an enabling environment for service expansion; • Increased access to a comprehensive package of HIV sexual prevention activities at sufficient intensity and quality; • Improved the continuum of community- and facility-based prevention, care and treatment for targeted MARPs; and, • Improved use of data to strategically prioritize and target MARPs, and plan HIV program interventions emphasizing evidence-based strategies. The project started effectively in May 2012. The ultimate objective of this study is to generate relevant information about the determinants of the behaviours exhibited by MARPs, contexts under which they practice these behaviours and their value systems, with the aim of providing evidence for improved programming. Primary objectives 1. Contribute to a better understanding of the context of MARPs in Nigeria and document factors that place MARPS at risk of HIV. 2. Describe how MARPs—including highly vulnerable subgroups—may be identified, reached, and served by various health programs 3. To feed the results of (1) and (2) back to HIV prevention programming in Nigeria This study will employ two approaches to obtain the information needed to achieve the set objectives. 1. Review of all existing literature to gather information. This search will be limited to Nigerian/sub-Saharan African literature related to MARPs, as well as secondary analysis of existing data such as the NARHS, IBBSS and ACASI. 2. Qualitative Study: Focus Group Discussions (FGD) and the Key Informant Interviews (KII) will be used to obtain information from respondents.