Individual and healthcare supply-related HIV transmission factors in HIV-positive patients enrolled in the antiretroviral treatment access program in the Centre and Littoral regions in Cameroon (ANRS-12288 EVOLCam survey)

• DOI: 10.1371/journal.pone.0266451
• Publication Date: 2022-04-06T17:41:06Z
• Authors: Pierre-julien Cou...; Abdourahmane Sow; Luis Sagaon-Teyssier; Khadim Ndiaye; Gwenaëlle Maradan; Christian Laurent; Bruno Spire; Laurent Vidal; Christopher Kuaban; Sylvie Boyer
• Keywords: Antiretroviral treatment

Despite great progress in antiretroviral treatment (ART) access recent decades, HIV incidence remains high sub-Saharan Africa. We investigated the role of individual and healthcare supply-related factors transmission risk HIV-positive adults enrolled 19 services Centre Littoral regions Cameroon.Factors associated with (defined as both unstable aviremia inconsistent condom use HIV-negative or unknown status partners) were identified using a multi-level logistic regression model. Besides socio-demographic behavioral variables, following four HIV-service profiles, cluster analysis, used analyses variables: 1) district large numbers patients, almost all practicing task-shifting not experiencing drugs (ARV) stock-outs (n = 4); 2) experienced well-equipped national reference services, most ARV 5); 3) small limited resources activities, 6); 4) wide range activities half 4).Of 1372 patients (women 67%, median age [Interquartile]: 39 [33-44] years) reporting sexual activity previous 12 months, 39% [min-max across services: 25%-63%] at transmitting HIV. The final model showed that being woman (adjusted Odd Ratio [95% Confidence Interval], p-value: 2.13 [1.60-2.82], p<0.001), having an economic (1.34 [1.05-1.72], p 0.019), least two partners (2.45 [1.83-3.29], disease symptoms diagnosis (1.38 [1.08-1.75], 0.011), delayed ART initiation (1.32 [1.02-1.71], 0.034) treated (2.28 [1.48-3.49], p<0.001) risk. Conversely, longer time since was lower (0.96 [0.92-0.99] per one-year increase, 0.024). Patients followed third profile had higher (1.71 [1.05-2.79], 0.031) than those first profile.Healthcare supply constraints, including chain deficiency may impact To reduce incidence, need adequate to relieve barriers provide suitable support throughout continuum care.