As millions of people with HIV live longer thanks to effective treatment, a Nigerian researcher has presented evidence at the world’s foremost HIV conference showing that preventing diabetes among them is not only medically beneficial but highly cost-effective, with direct consequences for how health systems spend limited resources.

The study was presented by Gabriel Ezenri, co-Principal Investigator of the Person-Centred HIV Research Team (PeCHIVReT) at the University of Nigeria, Nsukka, during the 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro, Brazil, which ran from 26 to 31 July 2026. It projected that integrating diabetes prevention into routine HIV care could cut the share of Nigerian adults on antiretroviral therapy who develop diabetes from a projected 18.4 per cent to 10.6 per cent over 15 years, while saving money overall.

The significance of the work lies in what it adds to a rapidly emerging global challenge. Antiretroviral therapy has transformed HIV from a fatal illness into a manageable chronic condition, but as patients age, chronic diseases such as diabetes are becoming a growing threat to their health and a rising cost to health systems. Evidence on whether preventing these conditions is economically justified in African settings has been scarce, a gap that leaves policymakers without the data they need to act. By quantifying both the health and the economic case, Mr. Ezenri’s study provides exactly the kind of evidence that can shift policy.

The team built an individual-level microsimulation model, a computational technique that simulates each patient’s trajectory year by year, using clinical data from 12,436 adults on treatment across three Nigerian states between 2010 and 2024. It projected outcomes under three scenarios: current care, annual metabolic screening, and integrated prevention combining screening with lifestyle counselling and preventive treatment. Under current care, projected diabetes incidence reached 18.4 per cent by 2039. Annual screening lowered it to 14.1 per cent, and integrated prevention to 10.6 per cent, a reduction of nearly eight percentage points. The integrated approach was estimated to cost an additional US$46 per person but to save roughly US$94 per person in later diabetes care, at US$287 per disability-adjusted life-year averted, with a greater than 92 per cent probability of being cost-effective under commonly used thresholds.

Melody Okereke, a pharmacist, policy analyst and global health researcher who attended the conference, described the work as an important addition to the evidence base. “This study makes an important contribution to HIV and health policy by demonstrating that the growing burden of diabetes among people receiving antiretroviral therapy can be addressed in a way that is both clinically beneficial and economically sound,” he said. “By using longitudinal Nigerian data to model the costs and outcomes of integrated prevention, Gabriel Ezenri and his colleagues provide locally relevant evidence for a policy question that has too often depended on findings from high-income settings. The results offer a compelling case for incorporating metabolic screening and diabetes prevention into routine HIV services and national financing frameworks. This is timely, rigorous and highly policy-relevant work that deserves serious consideration by health authorities, HIV programme implementers and funding institutions.”

Because HIV and diabetes services are typically funded and delivered through separate systems, patients are often not screened for metabolic risk until serious complications develop. The study makes the case that routine HIV appointments offer an untapped opportunity for prevention, and the researchers recommended embedding metabolic screening into national HIV treatment guidelines and financing frameworks so that implementation does not depend on temporary external funding. The team noted that the projections rest on modelling assumptions and that real-world implementation studies would be needed to confirm them.

Mr. Ezenri is co-Principal Investigator of the Person-Centred HIV Research Team at the University of Nigeria, Nsukka, and is also affiliated with the University of Arkansas for Medical Sciences in the United States, working at the intersection of HIV, health economics and health policy. His presentation was one of the abstracts accepted at AIDS 2026, the largest global gathering dedicated to HIV and AIDS, convened by the International AIDS Society since 1985 and drawing delegates from more than 130 countries, with research selected through international scientific review. By bringing rigorously modelled Nigerian evidence to this stage, Mr. Ezenri contributed to an international discussion about how to make HIV care comprehensive, sustainable and economically sound as patients age.