Nigeria is a sub-Saharan country with one of the highest rates of HIV, and other sexually transmitted diseases including Hepatitis B. In adult population, between the ages of 15-49 years, the prevalence of HIV infection is cited to be 3.5% while for Hepatitis B the numbers are even higher with approximately 7-10% of population affected. The HIV problem is further accentuated by the lack of access to diagnostic and treatment facilities. Many factors affecting access are poor socio-economic conditions, gender gap, lack of safe-sex practices as well as Stigma and discrimination still prevent people with HIV from disclosing their status and accessing services. Men and women not just have to worry about the status of their diseases but the process of going to a health facility to get their diagnosis is an ordeal in itself. Women especially unmarried are looked upon with suspicion and disgust if they are seen visiting a diagnostic service for HIV and other sexually transmitted diseases.
In this context of stigma around sexual activity, it is not surprising but unfortunate that in a country with rampant HIV infection only 10% of the population gets tested for HIV. It leads to delay in diagnosis and most of the cases are diagnosed at a stage too late for effective treatment. The government, non-governmental agencies, and professional groups undertake interventions to improve diagnosis rates; a recent similar project is called the “anonymous diagnosis.” The project implemented by a local NGO involves distributing “SlideSafe packages,” these packages are brightly-colored and do not reveal their contents. The package contains self-testing kits for HIV, Hepatitis B and syphilis and contraceptives for both men and women. The kit is economically priced at 2,000 to 7,500 Naira ($5-20), and it can be bought from the startup’s website with complete privacy, and a provision of counseling is also available keeping in view the anxiety and nervousness of people contemplating self –testing.
Most of the medical and public health experts agree that self-testing is a reliable, efficient method for diagnosis of HIV and other sexually transmitted diseases. However, there are concerns as well such as the potential of self-harm/ suicide and partner violence on a positive diagnosis of HIV. Secondly, self-testing kits perform screening tests only, and confirmatory tests and further management need a medical care facility. Therefore, a partnership between public-private organizations, health care experts, and community groups is required to make better use of innovations, develop a trust in the health system and bring about a cultural change.