In Nigeria, where the HIV epidemic continues to challenge public health systems, innovative strategies for prevention and care are critical. An Assistant Director at the Federal Ministry of Health and a field epidemiologist, Dr. Irene Esu, has been at the forefront of HIV management, particularly among key populations. Her work has garnered national and international recognition, demonstrating the importance of targeted interventions and robust health systems in tackling the epidemic.
In this interview, Esu discusses the state of HIV prevention in Nigeria and her vision for the future of HIV management in the country.
What role does public education play in HIV prevention among key populations, and what strategies have proven effective?
Public education is vital in reducing stigma and promoting preventive measures. Effective strategies include peer-led outreach programs, which have been instrumental in disseminating accurate information within key population networks. We’ve also leveraged digital platforms to share educational content and increase awareness. These initiatives, combined with community engagement efforts, have helped shift perceptions and encourage people to access testing and treatment services.
Nigeria has made strides in HIV management, but key populations remain disproportionately affected. What are the main challenges you’ve encountered in addressing this issue
Key populations, such as sex workers, men who have sex with men and people who inject drugs, face unique challenges that make them more vulnerable to HIV. Stigma and discrimination remain significant barriers to accessing healthcare services. Many individuals in these groups are hesitant to seek treatment or testing for fear of being judged or ostracised. Additionally, structural barriers, such as limited access to healthcare facilities in remote areas and inadequate funding for targeted programs, exacerbate these challenges.
Your leadership in implementing the Differentiated Service Delivery (DSD) model in Nigeria has been widely recognised. How has this approach impacted HIV care among key populations?
The DSD model has been transformative in ensuring continuous access to high-quality antiretroviral therapy (ART). By tailoring HIV care to the specific needs of individuals and communities, we have been able to reach more people, including key populations. For instance, decentralised service delivery through community-based models has brought care closer to those who need it most, reducing the burden of frequent hospital visits. This approach has not only improved adherence to treatment but also fostered trust and engagement among marginalised groups.
With your extensive experience in public health, what measures do you believe are critical for sustaining progress in HIV prevention and management?
Sustained progress requires a multi-pronged approach. Strengthening health systems, particularly in terms of funding and infrastructure, is essential. Expanding access to PrEP (pre-exposure prophylaxis) and ensuring the availability of ART for all who need it are critical. Furthermore, addressing social determinants of health, such as poverty and education, will help reduce vulnerabilities among key populations. Collaborative efforts with civil society organisations, international partners, and the private sector are also necessary to ensure that programs are adequately funded and effectively implemented.
Looking ahead, what is your vision for HIV prevention and care in Nigeria?
My vision is a Nigeria where no one is left behind in the fight against HIV. This means achieving universal access to testing, treatment, and preventive services, regardless of an individual’s background or circumstances. It also involves building a health system that is resilient, inclusive, and responsive to the needs of all populations. By continuing to innovate, collaborate, and advocate, I am confident that we can achieve an AIDS-free generation in Nigeria.
