Expanding Access to Hepatitis C Diagnosis: The Jhpiego HCV Self-Testing Research in Nasarawa State

Viral hepatitis C remains an under-recognized public health challenge in Nigeria despite its significant burden, especially among high-risk populations and people living with HIV. Traditional facility-based testing approaches often fail to reach many individuals due to stigma, limited access, and gaps in awareness. In response, innovative strategies such as Hepatitis C virus self-testing (HCVST) are being explored to expand testing, improve early diagnosis, and strengthen linkage to care.

In Nasarawa State, Jhpiego, through its STAR Nigeria research initiative, is conducting implementation research to evaluate the feasibility, acceptability, and linkage outcomes of HCV self-testing among key populations and people living with HIV. This research represents one of the first systematic efforts in Nigeria to generate evidence on how HCVST can be delivered effectively in real-world settings and inform future national strategies for viral hepatitis elimination.

What the HCV Self-Testing Research Is Exploring

The study in Nasarawa State focuses on introducing both blood-based and oral fluid HCV self-test kits within clinical and community settings connected to antiretroviral treatment (ART) clinics and one-stop shops serving key populations. The goal is to understand how different delivery models perform, including:

• Feasibility of Self-Testing Models: Can HCV self-testing be implemented reliably in ART clinic environments and community outreach sites?
• Acceptability Among High-Risk Groups: Are individuals willing to use HCVST kits, and do they find the process user-friendly and culturally appropriate?
• Linkage to Confirmatory Testing and Treatment: After a reactive self-test result, how effectively are participants linked to confirmatory RNA PCR testing and subsequent treatment?
• Service Delivery and Distribution Models: What approaches are most effective in reaching underserved populations, including people living with HIV and key populations traditionally missed by facility-centric systems?

Preliminary findings from the research in Nasarawa indicate that HCV self-testing is both feasible and acceptable among participants. Among those who had reactive self-test results, nearly all received confirmatory RNA PCR testing, and a high proportion initiated and completed treatment once diagnosed. The research suggests promise for HCVST as a strategy that can accelerate HCV diagnosis and care in Nigeria’s efforts toward viral hepatitis elimination.

Why HCV Self-Testing Matters

HCV self-testing offers several potential advantages in resource-limited and stigma-affected settings:

• It reduces barriers tied to traditional facility access, such as travel time, costs, and fear of discrimination.

• It empowers individuals to know their HCV status privately and at their convenience.

• It can be integrated into existing HIV and sexual health outreach systems, using channels established for HIV self-testing and peer-led services.

Emerging research across Nigeria also highlights strong stakeholder support for HCVST as a tool for expanding diagnosis and control of hepatitis C nationally. Surveys of stakeholders and health professionals show that most perceive HCVST as important for increasing disease detection, improving access, and potentially reducing stigma associated with hepatitis C testing.

Olive Right’s Role in Nasarawa

As an implementing Community-Based Organization in Nasarawa State, Olive Right to Health Initiative is contributing to this research by supporting community engagement, mobilizing participants, and facilitating linkage with both testing sites and follow-up services. ORHI’s community networks and outreach structures help ensure that high-risk and underserved populations are informed about HCVST opportunities and supported throughout the testing and care continuum.

Working alongside Jhpiego and other partners, Olive Right helps translate research evidence into actionable community practice ensuring that self-testing models are responsive to local needs, respectful of participants’ dignity and confidentiality, and connected to comprehensive care pathways.

Looking Forward

The evidence generated by the HCV self-testing research in Nasarawa State has the potential to influence national policy and scale-up strategies for hepatitis C services in Nigeria. By demonstrating how self-testing can expand diagnosis and improve treatment linkages, this work aligns with broader public health goals to close the viral hepatitis diagnosis gap and move closer to the World Health Organization’s elimination targets.

As research continues and implementation evolves, community partners like Olive Right will remain critical to ensuring that innovative testing approaches reach the people who need them most bringing us closer to a future without preventable viral hepatitis disease.