UNICEF recrute un analyse du conseiller international des adolescents et des jeunes dans le IBBSS 2019 au Nigéria

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Background and Rationale :

Nigeria is the most populous country in Africa, with an estimated population of approximately 180 million with approximately 9% of the people living with Human Immunodeficiency Virus (HIV) in the country (UNAIDS, 2014) From 1985 when the first case of HIV was diagnosed in a 13 year old Female Sex Worker (Nasidi and Harry 2006), the HIV epidemic has since transformed from a concentrated epidemic, with only a few population groups with higher risk behaviours affected, to a generalized epidemic in all states.

The adult HIV prevalence among antenatal clinic attendees increased from 1.8% in 1991 to 5.8 in 2001 and later dropped to 4.1 in 2010 (2010 ANC). The 2007 estimated HIV prevalence among the general population was 4.0% among females and 3.2% among males (FMOH 2008). These percentages translate to millions of infected people, with an estimate of 3.1 million individuals living with HIV by the end of 2012. The recent 2018 NAIIS result indicates that Nigeria’s HIV prevalence amongst adults is 1.4 % (15-49 years) and 1.5% (15-64 years). HIV prevalence is highest amongst females 30-35years at 3.3% and highest amongst males 50-54 years at 2.3%.32% of all new infections were from the ) 15-24 age group. One in every 3 new infections is among Adolescents and Young People (AYP) 15-24 (31.3%), Female AYP have double the new infection and prevalence rates of male of the same age group (NAIIS 2018).

One of the earliest national responses to the HIV & Acquired Immune Deficiency Syndrome (AIDS) epidemic in Nigeria was to set up a surveillance system to determine the magnitude of the HIV problem, as well as monitor trends of the epidemic. The surveillance involved prevalence rates for HIV and syphilis among various groups such as women attending antenatal clinics, blood donors, transport workers and patients attending Sexually Transmitted Infection (STI) and tuberculosis (TB) clinics. HIV sentinel surveillance, becomes less useful as an epidemic matures. This is because the chronic nature of HIV infection leads to slower changes in HIV prevalence in response to behavioural changes in populations. While sentinel surveillance can provide information about the distribution of the virus in the population, this information is limited to explaining what drives the epidemic or in informing the type of interventions needed, as well as assessing the effectiveness of such interventions. HIV surveillance data alone cannot indicate whether prevention interventions are having their desired effect of changing behaviours. More recently, behavioural surveillance survey was added on a larger scale to determine and monitor the knowledge, attitudes and behaviour associated with HIV and STI infections among the general population and selected groups of interest. Repeated behavioural surveys, can capture trends in behavioural change that lead to reduced HIV infection. The FMoH commissioned the first Integrated Biological and behavioural Surveillance Survey (IBBSS) in 2007. The introduction of biological component into this survey was first of its kind in Nigeria. A follow up survey was conducted in 2010 and subsequently in 2014.

Ending AIDS depends on greater efforts to reduce new HIV infections and prevent AIDS-related deaths among Key Populations (KP) at highest HIV risk, including males who have sex with males, sex workers, and people who inject drugs. Data are generally limited for adolescent, however, studies from low and concentrated epidemic countries show that HIV prevalence is disproportionately high among adolescents, aged 10-19 years, who sell sex, engage in same-sex relationships, and inject drugs. Due to cultural sensitivities and unfriendly legal frameworks, policy makers are often in denial about high risk behaviours amon st adolescents. This laces adolescents at even hi her risk of HIV infection and creates barriers to HIV testing, and, when needed, essential care and treatment. The IBBSS questions are very sensitive and making it difficult to collect data from adolescents. This has promulgated a continuous lack of systematic collection, analysis, and interpretation of data on AKP needed for the planning, implementation, and evaluation of essential HIV programs

All the three IBBSS conducted in Nigeria so far captured some elements of data analysis to understand what is happening among adolescents and young people aged 15-24 years. However, the level of analysis and description of the situation of these members of the population have been very limited. It is very pertinent that National HIV programs begin to address the challenges of this dearth of strategic information in a very systematic way. Learning from countries like the Philippines and Indonesia who closed the data gap, Nigeria is poised to ensure that the issues of AYP are adequately addressed in the upcoming IBBSS 2019.

 

The Purpose of the Assignment :

The proposed 2019 IBBSS will measure behavioural risk factors and HIV status among selected key and vulnerable populations in Nigeria. It aims to complement the knowledge gained so that viable education, prevention, and treatment programmes can be designed and implemented. This will provide valuable information for stakeholders for describing and understanding HIV dynamics and the effects of interventions.

This consultancy shall ensure that the issues of AYP aged 15-24 years are well addressed and articulated at every stage of the survey starting with the protocol development down to report writing and dissemination, with the aim of enhancing evidence-informed, strategic, and targeted funding allocations and programs toward ending AIDS among AKP.

Major Tasks to be accomplished: (estimated time required to complete tasks. Attach additional sheets, if necessary, to describe assignments) Strengthen national capacity for the integration of AYP in national surveys including conduct of analysis by national staff, putting in place measures/frameworks for inclusion of AKP in the IBBSS activities, counselling and ethical issues — consent issues, addressing abuse, violence and other protection issues that might emerge, inclusion of older adolescents as part of the data collection and analysis team.

Develop products that provide will concisely provide strategic information to respond to the specific needs of AYP KP, age of initiation of drug use or sexual behavior for advocating new policies to benefit AKP, including overlapping risks (ie, adolescents who inject drugs and sell sex), sexual behaviors, barriers to service uptake, violence, as well as HIV- and non-HIV-related (ie, reproductive and mental) health needs

Develop a separate shadow chapter to capture the issues of AYP

Discussion chapter to provide detailed comparative analysis of the situation for AYP when compared with the general population

Generate behavioural data to :

• Assess knowledge and beliefs of key and vulnerable populations about STIs, HIV & AIDS. Determine their current risk behaviours ;
• Assess key target population-level trends in risk behaviours over time Identify higher-risk sub-populations among these populations ;
• To determine the percentage of HIV positive persons who know their status ;
• To determine the percentage of HIV positive persons who know their status that are receiving ART.

Conduct trend analysis for key indicators using IBBSS 2007, 2010, 2014, 2019, disaggregate all existing data of adolescents in adult IBBSS and size estimations in the country into adolescent age groupings, disaggregate AYP data by state

Provide technical support for the design and set up of ongoing AYP data analysis work of the Health and HIV section (trendlines, shadow score cards, dash boards etc)

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