Low antiretroviral therapy uptake and low early retention among pregnant women who tested positive for human immunodeficiency virus in informal health centers in urban and semi-rural settings in Cameroon: a prospective cohort study
IntroductionDespite the efforts of Cameroon’s Ministry of Public Health against informal health centers (IHCs) because of their illegitimacy, the number of IHCs is increasing in Cameroon. Most of these IHCs have antenatal care services and screen pregnant women for HIV. However, nothing is known abo...
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1188749/full |
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| author | Audrey Amboua Schouame Onambele Audrey Amboua Schouame Onambele Francis Yuya Arielle Andtoungou Schouame Sylvie Kwedi Nolna Sylvie Kwedi Nolna Antoine Socpa |
| author_facet | Audrey Amboua Schouame Onambele Audrey Amboua Schouame Onambele Francis Yuya Arielle Andtoungou Schouame Sylvie Kwedi Nolna Sylvie Kwedi Nolna Antoine Socpa |
| author_sort | Audrey Amboua Schouame Onambele |
| collection | DOAJ |
| description | IntroductionDespite the efforts of Cameroon’s Ministry of Public Health against informal health centers (IHCs) because of their illegitimacy, the number of IHCs is increasing in Cameroon. Most of these IHCs have antenatal care services and screen pregnant women for HIV. However, nothing is known about the subsequent outcomes of those who tested positive for HIV. This study aimed to assess the initiation of antiretroviral therapy (ART) in ART-naïve pregnant women screened HIV positive in IHCs within three months of diagnosis and their ART retention at three months post-initiation. In addition, we sought to identify the factors associated with ART non-initiation in this population.MethodsMay 01, 2019 to August 31, 2020, we carried out a prospective cohort study of ART-naïve pregnant women who attended their first antenatal care visit and screened HIV positive at IHCs in the cities of Douala and Ebolowa in Cameroon. Standardized questionnaires were used to interview consenting participants at three points: the day of the delivery of the antenatal HIV test result, three months later, and three months after ART initiation. The data collected were entered into KoboCollect and analyzed using SPSS V23.0 software. The Chi-square test was used to compare proportions, Kaplan Meier techniques and Cox proportional hazards regression was used to estimate retention in ART and identify factors associated with ART non-retention, respectively.Results and discussionA total of 85 ART-naïve pregnant women living with HIV were enrolled in the study. The median age and gestational age at the first antenatal care visit were 29 years (interquartile range (IQR), 2333.5) and 28weeks of amenorrhea (IQR, 2032), respectively. Only 34% (29/85) initiated ART, and 65.5% (19/29) of the initiators were retained in ART three months later. Lack of perceived self-efficacy to initiate ART (adjust Hazard Ratio = 5.57, 90% CI: 1.29 to 24.06), increased the probability of not be retaining in ART by any time during three months post initiation. Given the low ART uptake and the low retention in care among pregnant women living with HIV screened in IHCs, PMTCT policies in Cameroon should pay greater attention to this population, to facilitate their continuum of PMTCT care. |
| first_indexed | 2024-03-12T20:33:38Z |
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| id | doaj.art-c81f4f55febd4877bcf07fd01c8d16e3 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-12T20:33:38Z |
| publishDate | 2023-07-01 |
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| series | Frontiers in Public Health |
| spelling | doaj.art-c81f4f55febd4877bcf07fd01c8d16e32023-08-01T16:00:55ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-07-011110.3389/fpubh.2023.11887491188749Low antiretroviral therapy uptake and low early retention among pregnant women who tested positive for human immunodeficiency virus in informal health centers in urban and semi-rural settings in Cameroon: a prospective cohort studyAudrey Amboua Schouame Onambele0Audrey Amboua Schouame Onambele1Francis Yuya2Arielle Andtoungou Schouame3Sylvie Kwedi Nolna4Sylvie Kwedi Nolna5Antoine Socpa6Department of Public Health, School of Health Sciences, Catholic University of Central Africa, Yaoundé, CameroonInstitut de Recherche pour le Développement France, Yaoundé, CameroonEpicentre, Niamey, NigerDepartment of Disease, Epidemics, and Pandemics Control, Ministry of Public Health, Yaoundé, CameroonCapacity for Leadership Excellence and Research (CLEAR), Yaoundé, CameroonDepartment of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, CameroonCenter for Applied Social Sciences, Research and Training (CASS-RT), Yaoundé, CameroonIntroductionDespite the efforts of Cameroon’s Ministry of Public Health against informal health centers (IHCs) because of their illegitimacy, the number of IHCs is increasing in Cameroon. Most of these IHCs have antenatal care services and screen pregnant women for HIV. However, nothing is known about the subsequent outcomes of those who tested positive for HIV. This study aimed to assess the initiation of antiretroviral therapy (ART) in ART-naïve pregnant women screened HIV positive in IHCs within three months of diagnosis and their ART retention at three months post-initiation. In addition, we sought to identify the factors associated with ART non-initiation in this population.MethodsMay 01, 2019 to August 31, 2020, we carried out a prospective cohort study of ART-naïve pregnant women who attended their first antenatal care visit and screened HIV positive at IHCs in the cities of Douala and Ebolowa in Cameroon. Standardized questionnaires were used to interview consenting participants at three points: the day of the delivery of the antenatal HIV test result, three months later, and three months after ART initiation. The data collected were entered into KoboCollect and analyzed using SPSS V23.0 software. The Chi-square test was used to compare proportions, Kaplan Meier techniques and Cox proportional hazards regression was used to estimate retention in ART and identify factors associated with ART non-retention, respectively.Results and discussionA total of 85 ART-naïve pregnant women living with HIV were enrolled in the study. The median age and gestational age at the first antenatal care visit were 29 years (interquartile range (IQR), 2333.5) and 28weeks of amenorrhea (IQR, 2032), respectively. Only 34% (29/85) initiated ART, and 65.5% (19/29) of the initiators were retained in ART three months later. Lack of perceived self-efficacy to initiate ART (adjust Hazard Ratio = 5.57, 90% CI: 1.29 to 24.06), increased the probability of not be retaining in ART by any time during three months post initiation. Given the low ART uptake and the low retention in care among pregnant women living with HIV screened in IHCs, PMTCT policies in Cameroon should pay greater attention to this population, to facilitate their continuum of PMTCT care.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1188749/fullHIVPMTCTinformal health centerspregnant womenART naïves |
| spellingShingle | Audrey Amboua Schouame Onambele Audrey Amboua Schouame Onambele Francis Yuya Arielle Andtoungou Schouame Sylvie Kwedi Nolna Sylvie Kwedi Nolna Antoine Socpa Low antiretroviral therapy uptake and low early retention among pregnant women who tested positive for human immunodeficiency virus in informal health centers in urban and semi-rural settings in Cameroon: a prospective cohort study Frontiers in Public Health HIV PMTCT informal health centers pregnant women ART naïves |
| title | Low antiretroviral therapy uptake and low early retention among pregnant women who tested positive for human immunodeficiency virus in informal health centers in urban and semi-rural settings in Cameroon: a prospective cohort study |
| title_full | Low antiretroviral therapy uptake and low early retention among pregnant women who tested positive for human immunodeficiency virus in informal health centers in urban and semi-rural settings in Cameroon: a prospective cohort study |
| title_fullStr | Low antiretroviral therapy uptake and low early retention among pregnant women who tested positive for human immunodeficiency virus in informal health centers in urban and semi-rural settings in Cameroon: a prospective cohort study |
| title_full_unstemmed | Low antiretroviral therapy uptake and low early retention among pregnant women who tested positive for human immunodeficiency virus in informal health centers in urban and semi-rural settings in Cameroon: a prospective cohort study |
| title_short | Low antiretroviral therapy uptake and low early retention among pregnant women who tested positive for human immunodeficiency virus in informal health centers in urban and semi-rural settings in Cameroon: a prospective cohort study |
| title_sort | low antiretroviral therapy uptake and low early retention among pregnant women who tested positive for human immunodeficiency virus in informal health centers in urban and semi rural settings in cameroon a prospective cohort study |
| topic | HIV PMTCT informal health centers pregnant women ART naïves |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1188749/full |
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