Abstract

Introduction:The test-and-treat strategy related to HIV, seems to have yielded inconsistent results in Cameroon. We explored how biomedical aspects and side effects related to HIV first-line ART regimen might impact adherence to treatment, and overall outcomes of HIV infected individuals, within the test-and-treat strategy in Cameroon.

Methods: We conducted a qualitative and quantitative study with PLHIV. BMI values, liver and kidney related lab examinations were determined at inclusion and 6 months later, including VL. Follow up information were collected on a monthly basis. FGD sessions were carried out and analyzed by Atlas Ti 6.2.

Results: 155 PLHIV were included, and contributed 423 person-months of follow-up. TDF/3TC/EFV was prescribed to 63 participants (40.6%; - CI_95%: 32.8% - 48.8%) at inclusion, whereas 92 received TDF/FTC+EFV at inclusion (59.4%; - CI_95%: 51.2% - 67.2%), as first line treatment (p = 0.02144). 9 participants died during the study (CMR: 5.8%). Out of 930 expected follow up visits, 346 (37.2%; [CI_95%: 34.1% - 40.4%]) occurred. 31 participants received their viral load results, and 93.5% were virally suppressed. Being a female (AOR = 3.05, 95%CI: 1.65 – 7.36), adhering to ART (AOR=2.05, 95% CI: 1.21 – 5.24) and not experiencing any side effects (AOR = 2.15, 95%CI: 1.25 – 5.66) were significantly associated with suppressed VL. Also being a male (AOR = 3.01, 95%CI: 1.25 – 6.34), having high levels of creatinine at initiation (AOR=2.01, 95% CI: 1.69 – 6.32), not adhering to ART (AOR=3.50, 95% CI: 1.98 - 7.01) and receiving treatment in district hospital biyemassi (AOR = 2.21, 95%CI: 1.69 – 7.36) were significantly associated with mortality. Under the qualitative component, 76 codes, 07 themes and 16 subthemes were identified. Among the themes identified were the limiting factors/enabling environment, overall perceptions, skills development, denial, missed appointments and other considerations in relation to PLHIV and ARVs, and side effects.

Conclusion: Poor retention in ART treatment continues to be the main issue in the implementation of the test-and-treat strategy. Occurrence of side effects, poor communication between service providers and PLVIH, as well as lack of therapeutic education, were identified as being some of the root causes of poor retention and adherence to ART.

Keywords: HIV; Test-and-Treat; ARV; Side Effects; Adherence; Viral Load

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Citation

Citation: R Medang., et al. “Implementation of the HIV Test-and-Treat Strategy in PEPFAR Supported Health Facilities in Yaoundé-Cameroon: Antiretroviral Side Effects, Retention and Viral Load Suppression Outcomes".Acta Scientific Nutritional Health 4.1 (2020): 96-124.

Copyright

Copyright: © 2020 R Medang., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.