Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 10, 2020
Date Accepted: Jan 2, 2021
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Mapping key population hotspots in Nigeria for targeted HIV program planning
ABSTRACT
Background:
With the fourth highest HIV burden globally, Nigeria is characterized as having a mixed HIV epidemic with high HIV prevalence among key populations (KP), including female sex workers (FSW), men who have sex with men (MSM), and people who inject drugs (PWID). Reliable and accurate mapping of KP hotspots is necessary for strategic placement of services and allocation of limited resources for targeted interventions.
Objective:
We aimed to map and develop a profile for FSW, MSM, and PWID hotspots in seven states of Nigeria to inform HIV prevention and service programming and in preparation for a multiple-source capture-recapture population size estimation effort.
Methods:
In August 2018, 261 trained data collectors from 36 KP-led community-based organizations (CBOs) in seven United States President’s Emergency Plan for AIDS Relief (PEPFAR) priority states mapped, validated, and profiled hotspots identified during the formative assessment. Hotspots were defined as physical venues where KP members frequent to socialize, seek clients and/or engage in KP-defining behaviors. Hotspots were visited by data collectors and each hotspot’s name, local government area (LGA), address, type, geographic coordinates, peak times of activity, and estimated number of KP members were recorded. The number of KP hotspots per LGA were tabulated from the final list of hotspots.
Results:
A total of 13,899 KP hotspots were identified and mapped in the seven states, including 1,297 in Akwa Ibom, 1,714 in Benue, 2,666 in Cross River, 2,974 in Lagos, 1,550 in Nasarawa, 2,494 in Rivers and 1,204 in the Federal Capital Territory. The most common hotspots were those frequented by FSW (69.0%), followed by PWID (19.6%), and MSM (11.3%). More hotspots were found in metropolitan LGAs and state capitals, although hotspots were identified in all LGAs visited.
Conclusions:
A total of 13,899 KP hotspots in the seven states were identified; more than previously reported in similar studies in Nigeria. Close collaboration with KP-led CBOs facilitated identification of many new and previously undocumented KP hotspots in the seven states. The small number of MSM hotspots (n=1,577) relative to FSW (n=9,593) and PWID (n=2,729) hotspots may reflect the social pressure and stigma faced by this population.
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