Abstract
Background: In 2021, Nigeria had an estimated 1.9 million people living with HIV (PLHIV) and 1.7 million (90%) on antiretroviral therapy (ART). However, it is unclear what proportion remains on treatment long enough to achieve and maintain viral suppression. This meta-analysis synthesizes evidence on the proportion of PLHIV on ART retained in care in Nigeria.
Study Design: A systematic review and meta-analysis.
Methods: This meta-analysis followed the PRISMA 2020 guidelines. We searched PubMed, Embase, PsychINFO, CINAHL, Global Index Medicus, and Cochrane Library. Studies were included if they reported on ART retention in care among PLHIV in Nigeria. The random-effects meta-analyses were used to combine the studies that had complete retention data. The I2 statistic was used to assess the heterogeneity of the studies. A sensitivity analysis was done by conducting a leave-one-out analysis. Data were analyzed using STATA version 18.
Results: The search yielded 966 unique articles. Fifty-two studies met the inclusion criteria for the meta-analysis, and four experimental studies were split into their component arms. The total number of study participants was 563,410. Pooled retention rate was 72% (95% CI: 67%, 76%; I2 = 99.9%; n = 57). Sub-analysis showed that the South-East region of Nigeria had the highest retention of 86% (95% CI: 78%, 92%), and the South-South the lowest (58%; 95% CI: 38%, 79%).
Conclusions: In Nigeria, the pooled ART retention rate is far below the UNAIDS goal of 95% and developing new models for ART retention is needed.