Professional Practices in HIV Counselling and Testing at Secondary Health Facilities in Oyo State

HIV counselling and testing (HCT) is the entry point into Nigeria's HIV care cascade, and the professional quality of HCT services directly determines uptake of antiretroviral therapy and viral suppression outcomes. This study appraises the professional practices of healthcare workers delivering HCT services at secondary health facilities in Oyo State, South West Nigeria. A cross-sectional observational and self-report study will be conducted at 15 secondary hospitals across Ibadan, Ogbomosho, and Oyo metropolis. HCT service providers including nurses, community health extension workers, and counsellors will be observed during simulated counselling sessions using a standardised checklist aligned with the National Guidelines for HIV Counselling and Testing in Nigeria. Provider knowledge of HIV test algorithms, pre- and post-test counselling content, disclosure support, and linkage to care will be evaluated. Administrative records will be audited for documentation completeness and test kit quality assurance. A national HCT quality assessment conducted in 2022 identified significant disparities in counselling quality between urban and peri-urban secondary facilities. Findings will identify specific competency gaps in Oyo State HCT providers, informing the state's response for targeted continuous professional development and supportive supervision of facility-level HCT services. Keywords: HIV counselling and testing, professional practice, healthcare workers, Oyo State, HIV care cascade