The Lagos State AIDS Control Agency (LSACA) works to achieve Fast-Track City objectives with a number of partners. It has engaged the private sector in initiatives to improve HIV sensitivity in workplaces and to fund the HIV response. It has also worked with teachers and youth-oriented service workers to improve education and services for adolescents and young people.
Engaging the private sector
LSACA is working in close collaboration with the Fast-Track City project and the private sector to improve the city’s HIV response. The agency has established strong partnerships with 30 key private sector players in Lagos to promote the integration of Nigeria’s National Workplace Policy on HIV/AIDS, which aims to protect people living with HIV and promote and ensure respect for their rights. Human resource (HR) managers at each of the 30 organizations received workplace policy documents for adoption and distribution, helping to entrench sensitivity to HIV issues into their operations. LSACA also provides training on the use and implementation of the workplace policy, covering basic facts about HIV; the rights of people living with HIV; countering stigma and discrimination in the workplace; and how to respond to rights abuses and refer cases to the appropriate authorities. Existing policy documents will be updated by the organizations, including to take into account new issues related to the COVID-19 pandemic.
The intervention has already had impacts, not least the initial willingness of organizations to adopt the policy and commit to building sensitivity and action around HIV. The partners have established onsite sensitization and awareness campaigns, and assigned responsibility for working with HR managers to ensure respect for staff members’ HIV-related rights. LSACA continues to monitor the implementation of the national policy. The State government will now work to increase the reach of the initiative and bring on board more private-sector organizations within and beyond Lagos city.
Other initiatives have also strengthened private-sector engagement. A private-sector round table meeting is held quarterly, and participants have been actively engaged in mitigation measures and support for people living with HIV during the COVID-19 pandemic, providing 1000 packs of emergency supplies including food and hygiene items.
The Nigeria Business Coalition against HIV/AIDS (NiBUCAA)– a group of private-sector organizations – is also working very closely with the Fast-Track City programme to champion the adoption of the workplace policy among its members. The Coalition’s corporate network, including extremely high-profile organizations such as Total Oil, Chevron, Shell, the Dangote Foundation and financial institutions, also contributes funds to the city’s HIV response.
A meeting between high-profile stakeholders, including the Executive Governor of Lagos and the managing director of Access Bank Plc, one of Nigeria’s leading financial institutions, was held to catalyse an increase in private contributions to the HIV response through the HIV Trust Fund of Nigeria (HTFN). This new private-sector initiative, promoted by NiBUCAA and Nigeria’s National Agency for the Control of AIDS (NACA) and supported by UNAIDS, will increase such contributions to around 10% of the national AIDS budget, up from 2% in 2016.
Mapping and improving youth-oriented services
Following analysis of city data that showed a lack of adequate programming for adolescents and young people, LSACA and UNAIDS undertook an exercise to map community structures and services for this population in Lagos State, including geographical distribution, types of service and gaps. The mapping was intended to assist in the integration of prevention and testing interventions for young people, which will increase equitable access to these services (including the distribution of self-test kits).
The process included facility surveys and GPS coordinate mapping in Lagos State’s 20 local government areas. UNAIDS assisted with locating and reaching sites and facilities that were more remote and/or difficult to access, thanks to their contacts with networks of young people.
A total of 36 structures for adolescents and young people, including community centres, were identified, of which 27 were functional. The map and report were disseminated to youth networks and organizations, implementing partners and other civil society organizations working with this population. They serve as a ‘directory’ of the location of, and services provided by, the centres, and thereby increase access to and uptake of services.
The city has also produced leaflets, posters, booklets and stickers to promote HIV prevention services among adolescents and young people and members of key populations. These materials were distributed, along with self-testing kits, to 31 of the structures, resulting in increased uptake of HIV testing services by young people. Other activities conducted by partners include the training of health care workers and HIV counselors in the structures to provide HIV services in a safe and stigma-free environment; to promote self-testing; and to update their HIV testing skills. Targeted community HIV testing is conducted in high-burden areas.
As a result of these activities, approximately 2700 adolescents and young people have already received HIV, reproductive and sexual health and related services in the 27 functional facilities.
The mapping exercise also provided baseline data on levels of access by adolescents and young people to these services, which will be used in the design of targeted interventions. A workplan to guide planning, coordination, monitoring and evaluation of such interventions has been developed and is being used by stakeholders and partners.
LSACA and other Fast-Track City project partners also engage with key and vulnerable populations in the planning and implementation of activities. For example, young people living with HIV were hired as research assistants for a Quality-of-Care survey implemented by IAPAC and the State Ministry of Health.
Example of the campaign: Promoting counseling and testing
Comprehensive sexuality education
Adolescents who receive comprehensive sexuality education are less likely to engage in sexual activity and more likely to engage in safer sexual behaviours. Recognizing this, Lagos recently revitalized the Family life and HIV Education (FLHE) programme in the city’s public secondary schools. The FLHE curriculum is taught to junior secondary school students during basic science and social studies courses and covers adolescent sexuality and reproductive health.
Crucial to the success of the programme is building the capacity of the teachers of these courses to teach the FLHE curriculum. This includes increasing their knowledge and awareness of – and comfort with – the content and enhancing their classroom delivery of the often-sensitive FLHE concepts. A five-day training-of-trainers workshop was held for 38 teachers in early 2021; since then, participants have gone on to train a further 378 teachers in all six education districts in Lagos State. Specific emphasis was placed on gender inequalities, the sexual experiences of young people and their right to accurate sex- and sexuality-related information and services.
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