Concerns about stigma and confidentiality limit the uptake of HIV testing and counseling (HTC) among young adults. HIV self-testing has been offered as a youth-friendly alternative to conventional HTC. We conducted a cross-sectional study to assess HTC uptake, willingness to self-test, and their predictors among university students ( n =  399) in Kano, Nigeria. Anonymous self-administered questionnaires were provided to participants. Adjusted odd ratios were generated for predictors with logistic regression models. The results showed that only 35.8% ( n =  143) of participants had previous HTC.Most respondents (70.4%, n =  281) were willing to self-test. HTC was associated with year of college (500 Level vs. 100 Level), adjusted odds ratio (AOR, [95% Confidence Interval (CI)] = 0.44 (0.19–0.97), campus residence (off- vs. on-campus, AOR = 0.45; 95%CI: 0.28–0.73), sexual activity in the past six months (AOR = 0.39; 95%CI: 0.24–0.64), willingness to self-test (AOR = 0.38; 95%CI: 0.22–0.66), and consistent condom use (AOR = 4.45; 95%CI: 1.41–14.08). Students who were older (≥ 30 vs. <20 years, AOR = 0.20; 95%CI: 0.05–0.90) and female (AOR = 0.56; 95%CI: 0.32–0.98) were less likely to be willing to self-test, whereas students who were more senior (500 Level vs. 100 Level, AOR = 5.24; 95%CI: 1.85–14.84), enrolled in clinical science programs (vs. agriculture, AOR = 4.92; 95%CI: 1.51–16.05) or belonging to “other” ethnic groups (vs. Hausa–Fulani, AOR = 2.40; 95%CI: 1.11–5.19) were more willing to self-test. Overall HTC uptake was low, but acceptability of self-testing was high. College seniority, age, ethnicity, and program of study were associated with willingness to self-test. Our findings support the feasibility of scaling up HIV self-testing among university students in Nigeria.

Background: People living with HIV (PLHIV) are at increased risk of COVID-19 acquisition, severe disease, and poor outcomes. Yet, little is known about COVID-19 vaccine hesitancy among PLHIV in high HIV burden countries such as Nigeria. Objective: This study aims to assess the acceptability of the COVID-19 vaccine and identify predictors and reasons for vaccine hesitancy among patients living with HIV and attending a tertiary hospital in Kano, northern Nigeria. Methods: Using a mixed-methods design, structured questionnaires were administered to a clinic-based sample of patients living with HIV (n=344), followed by 20 in-depth interviews with a sub-sample. Logistic regression and the framework approach were used to analyze the data. Results: Less than half (46.2%, n=159) of the respondents were willing to take the COVID-19 vaccine. Vaccine acceptance was higher among non-Muslim PLHIV (Adjusted Odds Ratio (aOR)=1.26, 95% Confidence Interval (95%CI): 1.10-4.00), persons with high-risk perception (aOR=2.43, 95%CI:1.18-5.00), those who were not worried about infertility-related rumors (aOR=13.54, 95%CI:7.07-25.94) and persons who perceived antiretroviral drugs are protective against COVID-19 (aOR = 2.76, 95%CI: 1.48-5.14). In contrast, vaccine acceptance was lower among persons who were not more concerned about the potential effects of COVID-19-HIV co-infection (aOR=0.20, 95%CI:0.10-0.39). The most common reasons for vaccine hesitancy included doubts about the existence of COVID-19, low-risk perception, anxiety about antiretroviral treatment-vaccine interactions, safety concerns, and infertility-related rumors. Conclusion: Covid-19 vaccine acceptance was low among PLHIV. COVID-19 vaccine acceptance was associated with respondents’ faith, risk perception, perception of the protective effects of antiretroviral treatment, concerns about COVID-19-HIV co-infection, and infertility-related rumors. Vaccination counseling should be integrated into HIV treatment services to improve COVID-19 vaccine uptake among PLHIV in Kano and similar settings.

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Background: Despite advances in prevention of mother-to-child HIV transmission, infants in Africa remain at risk of HIV acquisition from inappropriate feeding practices. Research aims: To assess maternal knowledge and predictors of appropriate infant feeding practices among HIV-infected mothers attending a tertiary facility in Kano, Nigeria. Method: A cross section of 203 HIV-positive mothers were interviewed using structured, pretested survey questionnaires. Knowledge scores and infant feeding practices were analyzed. Multivariate logistic regression was employed to ascertain independent correlates of infant feeding practices in the study sample. Results: Over a third (37.4%) of the participants were aware of the risk of HIV transmission through breastfeeding. The proportion of participants with good, fair, and poor knowledge of recommended feeding options for HIV-exposed infants was 4.4%, 73.4%, and 22.2%, respectively. About three in four participants (73.9%) breastfed their index infants exclusively for the first six months. Approximately 7.4% of respondents practiced mixed feeding (breastfeeding plus infant formula). Counseling on infant feeding (Adjusted Odds Ratio [AOR] = 2.16, 95% Confidence Interval [CI] = [1.58, 4.15]) and hospital delivery (AOR = 3.02, 95% CI = [2.67, 7.84]) predicted appropriate infant feeding practice. Conclusion: Appropriate infant feeding practices were significantly associated with prior infant feeding counseling and delivery in a hospital setting. HIV-infected mothers in this setting should receive counseling on infant feeding early in their pregnancy and be educated on the importance of hospital delivery.

Objective: Incident HIV infections in pregnant and breastfeeding mothers pose significant challenges to prevention of mother-to-child HIV transmission efforts in sub-Saharan Africa. We identified the predictors of willingness to self-test for HIV when retesting in pregnancy and postpartum among antenatal clients in a tertiary hospital in Northern Nigeria. Methods:Structured and validated questionnaires were administered to a cross section of antenatal attendees (n = 370) in March 2021. Willingness to self-test and adjusted odds ratios of potential predictors were generated from logistic regression models.Results: Of the 317 respondents who agreed to repeat HIV test during pregnancy, 29.3% (n = 93) were willing to self-test. Similarly, of those (n = 350) willing to retest after delivery, 27.4% (n = 96) were willing to self-test. Willingness to self-test during pregnancy was higher among respondents who were multiparous (2-4 births) (adjusted odds ratio, aOR = 2.40, 95% confidence interval CI, 1.14-6.43), employed (aOR = 1.49, 95% CI, 1.13-4.53)and those with at least secondary education (aOR = 2.96, 95% CI, 1. 43-11.47). In contrast, willingness to self-test was lower among those who were unaware of the husband's HIV status (aOR = 0.05, 95% CI, 0.02-0.13). Willingness to self-test after delivery was higher among respondents who were married (aOR = 15.41, 95% CI, 3.04-78.2), multiparous (aOR = 2.01, 95% CI, 1.27-5.63), employed (aOR = 1.59, 95% CI, 1.08-2.35) and had at least to secondary education (aOR = 6.12, 95% CI, 1.36-27.47). In contrast, willingness to self-test postpartum was lower among those who booked late (≥29 weeks) (aOR = 0.11, 95% CI, 0.022-0.52), those who were unaware of the risk of HIV transmission during breastfeeding (aOR = 0.29, 95% CI, 0.12-0.68) and participants who were unaware of the husband's HIV status (aOR = 0.076, 95% CI, 0.03-0.19). Conclusion: Willingness to self-test for HIV in pregnancy and postpartum was low in this population and was influenced by risk perception, socio-demographic and obstetric attributes. Communication interventions and training of potential mentor mothers among early adopters could improve self-testing in this group and similar settings.