Olubukola Ayinde is a Nigerian, living and working in Ibadan, Oyo State in Nigeria. She is a passionate advocate for treatment access, treatment literacy and treatment and adherence support, as well as well as bringing back ‘lost to follow-up’ patients to treatment. She has worked as a hospital pharmacist for 13 years, at an antiretroviral (ARV) therapy treatment site, based at the Oyo State Hospital.

“Nigeria has access to dolutegravir (DTG), it has been rolled out and is currently recommended as the preferred first-line treatment regimen. I will gladly recommend DTG for people living with HIV. DTG has demonstrated better efficacy than most other ARVs, it is better tolerated, easier to use, with far fewer side effects or adverse reactions.

In 2016, Nigeria had 220,000 (150 000 – 310 000) new HIV infections and 160 000 (110 000 – 230 000) AIDS-related deaths. There were 3 200 000 (2 300 000 – 4 300 000) people living with HIV in 2016, among whom 30% (19% – 42%) were accessing antiretroviral therapy – UNAIDS.

“Patients have come back to testify that they feel much better with DTG. There is improved quality of life and less interference with daily activity. They say it’s easier to use and the pill is smaller. It doesn’t make them lose sleep or have funny dreams and their memory is intact. These were all problems they told to us with their previous treatment.

“I particularly remember that one patient used to wet the bed with the previous regimen but, since taking DTG, that has stopped. Patients claim they generally feel much better and are able to carry out their daily activities without any hindrance.

“The major challenge is basically around DTG use in females and adolescent girls. In view of the contraindication in pregnancy and the poor uptake of family planning services in my country, some women are not able to access DTG. Female adolescents are not placed on DTG too for the same reasons. In my country, there are lots of religious and cultural biases around family planning services.

“Also the availability of recent viral load results being a criterion for switching to DTG has slowed down the uptake, because viral load result turnaround time can be as long as two months.

“It would be nice to have trained adherence counsellors to routinely talk to patients about DTG, linked to family planning services, so as to improve uptake.”

From January 2012 to December 2018, MPP generic manufacturing partners have supplied 219,000 patient-years of DTG and TLD treatment in Nigeria[1].

Source data:

UNAIDS country stats – Nigeria

Note:

[1] More sales have occurred through procurement agencies