Key Populations are the major drivers of the HIV epidemic in most settings; thus, identifying positive KPs and their sexual partners becomes a strong strategy in the effort to achieve the first UNAID 95 goal. This study describes the level of acceptability and outcome of PNS among HIV-positive KPs using the various approaches for PNS. A descriptive study of all HIV positives KPs initiating ART in 7 One-Stop-Shop facilities that accepted PNS was conducted over 3 months. With the consent of patients who accepted PNS, their partners were reached using any of the PNS approaches. Partners who consented for HTS were tested, and positives partners were linked to ART services. Data were analyzed to describe the acceptability and outcome of PNS among KPs. Only 846/2,486 (34%) positive KPs accepted PNS. The 846 KPs elicited 941 partners, out of which 938 (99.6%) accepted HTS. 421/938 (45%) of the partners tested positive compared to PWIDF (15%), MSM (7%), FSW (4%) and PWIDM (4%). 129/421 (31%) of the positive partners were already known positives, with 61% already on ART. The commonest method of PNS accepted among KPs was the passive method (54%), followed by the contract method (22%), provider-initiated (19%), and dual method (5%). There was poor acceptance of PNS among KPs and, the HIV positivity rate was much higher among their partners than any of the KPs sub-groups. The passive approach was the most preferred method of PNS among KPs. This should be considered strongly as we scale up PNS in Nigeria. Keywords: HIV/AIDS, Key Populations in Nigeria, Partner notification services, UNAIDS 95-95-95 targets.

Introduction: Health care wastes constitute a small stream of all waste generated by human yet proper disposal of this waste is a great concern because of its hazardous nature. Most developing countries have poor culture of hospital waste management due to competing medical needs and lack of commitment by hospital management. AIDS Support and Technical Assistant Resources (AIDSTAR1) a development partner supported government of Nigeria to build capacity of health care workers in line with World Health Organization (WHO) and national guideline on HCWM.. It is expected that this support would yield the desired result of improving HCWM in Nigeria. This study is to assess the level of implementation of national guideline on HCWM in Nigeria. Methodology: A cross sectional descriptive study was conducted using key informant interview and direct observation of HCWM practices in 5 facilities selected from 3 out of the 6 priority states supported by AIDSTAR1. The guideline on minimum package for HCWM in Nigeria was used as a tool for assessing level of implementation at each health facility. Results: There was marked improvement in HCWM practices across the facilities compared to only 2.5% of facilities who met minimum standard for HCWM as described in the baseline assessment in 2011. All the facilities had infection prevention committee and all the various types of waste boxes were available and used in the facilities for waste segregation. Wastes were evacuated to points of final disposal even though there were some operational challenges with the process. There was high awareness of the hazardous nature of hospital waste and the need to dispose them in a sanitary manner. Conclusion: Training of all cadres of health care workers including waste handlers, management staffs, and provision of necessary material for HCWM has lead to improved HCWM in Nigeria. It is hereby recommended that government should ensure that guideline for minimum package of healthcare waste management are continuously implemented in health facilities in line with the national policy on HCWM.

Introduction: Key Populations are disproportionately affected by HIV/AIDS in all settings. Unfortunately, reaching KPs with HIV intervention is a huge challenge because of stigma, discrimination, violence, and criminalization of KPs lifestyles. Because of lack of KP specific interventions, data on KPs ART outcomes is lacking. This study determined ART outcomes among KPs 6-months after initiation. Methodology: The study was a longitudinal study of all HIV positive KPs initiated on ART in 7 One-Stop-Shops from October 2016-March 2017. Both Time-1 and Time-2 data were abstracted from facility record after initiation and 6-month after for each patient. Data abstracted include: age, sex, marital status, educational level, employment status and ART outcome 6 months after initiation. Results: Sixty-seven percent of patients were retained on ART, 1.8% died, 20.6% were lost to follow up, 4.5% transferred to other facilities and 6.2% stopped ART by the end of the 6 th month. PWID had highest retention rate (74.6%) more than MSM (70.2%), while FSW had the least retention rate (65.4%) but highest transfer out rate (4.9%) more than MSM (4.7%). Factors positively associated with retention at 6 th months include: Being a male P=0.007; higher education P=0.000; employed patient P=0.000; living with sex partner P=0.000. Conclusion: This study has laid a baseline data for ART outcomes among KPs in Nigeria. Further study is however required to identify factors that could improve retention on ART among KPs. This is important if we must achieve the second and third 90s of UNAIDs 90.90.90 goals.

Introduction: WHO clinical staging and or CD4 were used as eligibility criteria for initiation and monitoring of patients on ART in Sub-Saharan African. With health facility-based ART services, most patients in Sub-Saharan African were initiated on ART at late WHO clinical staging. Data are lacking on the clinical staging at the initiation of community-based ART services in Nigeria. This study describes WHO clinical staging among key populations initiated on community-based ART services using WHO test and treat guideline in Nigeria. Methodology: This is a baseline data analysis of a longitudinal study of all KPs who initiated community-based ART services in 7 states in Nigeria. Time 1 data abstracted from facility records includes age and sex, marital, educational, and employment status and WHO clinical staging at initiation. Results: Eighty-two percent of participants were initiated at early WHO clinical staging (1& 2). Among KPs, 85% of FSW were initiated at the early stage, followed by MSM (75%) and then PWID (66%). More PWID (34%) were initiated at the late stage (3&4) followed by MSM (25%) and FSW (15%). Factors positively associated with early initiation include: being a female, sex partners living together, unemployment and low educational status. Conclusion: Community based ART services using test and treat guideline will improve early initiation of KPs on ART services. However, further study to identify reasons for late ART initiation among KPs is required to support programme effort to achieve the UNAIDS 90-90-90 goals.