PROJECT STEP-4-YP brings HIV self testing closer to Nigerian youths in riverine communities

Young people living in riverine communities of Rivers State, Nigeria face unique barriers when seeking HIV testing services. For communities separated by waterways, where healthcare access may require costly boat transportation and long journeys, routine HIV testing can become difficult. These challenges are further compounded by concerns about stigma, confidentiality, and limited youth friendly services.

To address these gaps, PROJECT STEP-4-YP (Self Testing Expansion via PPMVs for Young People) was launched to improve HIV self-testing access and awareness among young people in Port Harcourt and Obio Akpor Local Government Areas of Rivers State. The initiative trained about 300 Patent and Proprietary Medicine Vendors (PPMVs) to support HIV self-testing education, counselling, and referral services.

According to Pharm. Melody Okereke, HIV/AIDS Implementation science researcher and project lead of PROJECT STEP-4-YP, the intervention was designed around the realities of young people living in communities where healthcare access remains challenging.

“Healthcare services must be designed around the realities of the communities we serve. For many young people in riverine communities, the challenge is not only availability of services but whether they can access those services privately, conveniently, and without stigma”, he said.

Through the project, PPMVs received training on HIV self-testing procedures, counselling approaches, confidentiality, and referral pathways for confirmatory testing and treatment.

Evaluation findings showed improved provider readiness following the intervention. The proportion of PPMVs who believed HIV testing could only be conducted by trained medical professionals reduced from 68.3 per cent before training to 4.3 per cent after training. In addition, 86 per cent of trained providers reported intention to stock HIV self-testing kits within four weeks after the intervention.

The project also developed more than 300 HIV self-testing information materials adapted to locally relevant languages to address communication barriers in riverine communities.

According to Okoli Chidera Godfrey, advocacy lead of PROJECT STEP-4-YP, the findings demonstrate the importance of strengthening existing community healthcare structures. “PPMVs already play an important role in community healthcare access. By equipping them with the right knowledge and tools, we can strengthen HIV prevention services without creating parallel systems”, he noted.

The intervention also introduced a youth focused social media video challenge to increase HIV self-testing awareness and encourage young people to participate in HIV prevention conversations.

For Francis Nwanko Casmir, community engagement lead of PROJECT STEP-4-YP, the project reinforced the importance of meeting young people where they are. “Young people need health services that understand their realities. Combining trusted community providers with youth focused communication helps create a more acceptable pathway to HIV prevention”, said Francis.

The project team believes that lessons from PROJECT STEP-4-YP can support future HIV prevention efforts across Nigeria, particularly in communities where geography and stigma continue to affect access to sexual and reproductive health services.

PROJECT STEP-4-YP was supported through an implementation grant from INSPIRE Youth Health, an organization focused on supporting innovative, youth centered approaches to HIV prevention and care across Africa.