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Background: Very high rates of late or no ART initiation remains a persistent challenge to the achievement of PEPFAR 95-95-95 targets despites new NAIIS report stating prevalence of HIV in Nigeria as 1.5%. This study assessed the impact of accompanied referral (AR) and effective counseling (EC) on enrolment and ART treatment commencement of newly diagnosed HIV positive patients.    Methods: This study is a Quasi- experimental and analyzed routine program data on linkage from October 2017 – October 2019 for 45 health facilities in two States in South-West Nigeria. The first 6 months (Q1 and Q2 FY18) had no intervention while accompanied referral (AR) was implemented in Q3 and Q4 FY18. EC was implemented with AR in Q1&Q2 FY19 and was followed up till Q3 and Q4 FY19. Data analysis was done using SPSS and significance fixed at P < 0.05 Results: A total of 6114 newly identified HIV-positive clients were identified; mean age was 35.7 ± 13.9 and 31.5% were in the 30-39 years age bracket. Index Testing contributed 28.7% of the HIV positive Clients identified. Percentage Enrolment in Q1 and Q2FY18 increased from 65.8% and 65.6% respectively to 89.9% and 83.8% in Q3 and Q4 FY18. This increased to 99.6% in Q1FY19, 100% in Q2, 99.7% in Q3 and 99.9% in Q4FY19. Percentage linkage to ART in Q1 and Q2FY18 increased from 61.9% and 65.6% respectively to 85.4% and 75.7% in Q3 and Q4 FY18. This increased to 98.8% in Q1FY19, 99.5% in Q2, 99.7% in Q3 and 99.2% in Q4FY19. Conclusion: AR coupled with EC had the best impact on enrolment, initiation on ART, time to enrolment and initiation.

european journal of medical and health sciences

Impact of Accompanied Referral and Effective Counseling on Enrolment And Linkage to ART of Newly Identified HIV Positive Clients Toward Achieving Epidemic Control in South-Western Nigeria