DOI: 10.4103/jphpc.jphpc_29_25 ISSN: 2772-3666

The Dual Burden of Human Immunodeficiency Virus and Tuberculosis among Key Populations in Nigeria: Implications for Integrated Care

Paul Umoh, Olaniyi Felix Sanni, Kelvin Emenike, Roger Abang, Paul Amechi, Bartholomew Ochonye

Abstract

Background:

Key populations (KPs), including Men Who Have Sex with Men, Female Sex Workers, and People Who Inject Drugs, experience a disproportionately high burden of Human Immunodeficiency Virus (HIV) and tuberculosis (TB) due to stigma, discrimination, and limited access to healthcare. This study explores the dual burden of HIV and TB among KPs in Nigeria to recommend integrated care strategies.

Methodology:

A retrospective quantitative study design was utilized, analyzing secondary data from the Heartland Alliance database (2019–2024). SPSS version 28 was used for data analysis, with ethical approval ensuring confidentiality. The study focused on high-risk KPs in selected Nigerian states.

Results:

Findings showed that TB diagnosis among key populations relied mainly on symptom screening (66.3%), with fewer cases using chest X-rays (33.7%). Gene Xpert was the most common bacteriological test (79.9%), followed by LF-LAM and TB LAMP. Newly diagnosed TB cases accounted for 89%, with relapses making up 11%. A strong association with HIV/TB comorbidity was observed in Cross River State (adjusted odds ratio = 78.996; P < 0.001). Among individuals without comorbidity, 72.3% were placed on a 3-month isoniazid-rifampicin preventive regimen (3HR). Overall, 91.8% of key populations had successful TB treatment, while 8.2% did not. Females had higher odds of success than males (crude odds ratio [COR] = 13.611; P = 0.021), while World Health Organization Stage II was linked to lower success rates (COR = 0.127; P = 0.041).

Conclusion:

Integrated, community-led, and stigma-free healthcare approaches are crucial to reducing the dual burden and improving outcomes for these vulnerable groups.

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