Background: According to UNAIDS 2019, 52% of people worldwide living with HIV is on antiretrovirals (ARVs), HIV positive women representing 80% of them. This study aimed at highlighting the determinants of adherence to ARVs for HIV positive women enrolled in PMTCT programs in the West and North Regions of Cameroon. Methods: A descriptive and analytical cross-sectional study was carried out from February to September 2019 in three treatment centres in the West (Bafoussam Regional Hospital and Dschang District Hospital) and North (Garoua Regional Hospital) regions in Cameroon. Data were collected using a questionnaire administered face to face and encoded in Excel 2013, then analyzed using SAS version 7.8. P-values < 0.05 were considered statistically significant Results: One thousand (1000) women were interviewed. The mean age was 17 ±2 years (Range: 12 – 67 years); 231 (23.1%) were single. Overall, the prevalence of ART-adherence was 68.6%. After multivariate analysis using multiple logistic regression; having one HIV-infected children (aOR=60.9; 95%CI=[7.6; 489.1]; P=0.001), non-disclosure of serological status with the spouse/boyfriend (aOR=25.2; 95%CI=[9.2; 68.9]; P<0.001), not being educated (aOR=7.7; 95%CI=[4.4; 13.3]; P<0.001); and taking ARVs once or less daily (aOR=50; 95%CI=[20.0; 100.0]; P<0.001) were four risk factors for non-adherence. Conclusion: ART-adherence among Cameroonian pregnant women is still very far below UNAIDS target (95%), with four potential key determinants identified. As we are progressively moving towards the elimination of HIV vertical transmission in 2030 as advocated by UNAIDS, local policies should be reinforced in order to consolidate the strides made so far. Keywords: HIV, PMTCT, Pregnancy, Adherence, option B+, Cameroon.
The use of highly active antiretroviral therapy (HAART) transformed HIV infection to a chronic disease, and the complexity of the physiological disorders generated leads to the disruption of body fat distribution and insulin resistance. The resulting metabolic syndrome has rarely been investigated among people living with HIV/AIDS in Cameroon. The aim of the current work was to determine the prevalence of metabolic syndrome and associated factors among people living with HIV/AIDS under HAART at the Bafoussam Regional Hospital in Cameroon. A retrospective, cross-sectional study was conducted to collect demographic, clinical and therapeutic data from 371 people living with HIV/AIDS and who are under HAART at the Bafoussam Regional Hospital from November 2017 to February 2019. Abbott Real-time HIV-1 system, FACSCOUNT cytometer and FULLYSMART automates were used to determine HIV RNA level, CD4 cell count and biochemical parameters respectively. The metabolic syndrome was defined according to the International Diabetes Federation (IDF) and the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) criteria. The overall prevalence of metabolic syndrome was 37.74% by IDF and 28.84% by ATPIII. Among patients with metabolic syndrome, HDL-hypocholesterolemia was the most prevalent feature (92.14%). We found that aging (OR, 1.05; p, 0.005), HIV RNA level (OR, 3.42; p, 0.001), family history of metabolic and coronary heart disease (OR, 2.24; P, 0.04), alcohol consumption (OR, 4; P, 0.004) and nutritional supplements (OR, 3.5; P<0.001) were the independent predictors of metabolic syndrome. Male sex (OR, 0.22; p,<0.001), use of traditional medicines (OR, 0.28; P<0.001), Cotrimoxazole prophylaxis (OR, 0.45; p, 0.007) and Lamivudine-Tenofovir-Efavirenz antiretroviral regimen (OR, 0.26; p<0.001) were protective factors. The prevalence of metabolic syndrome is on the increase among people living with HIV/AIDS in our study population. Both HIV related factors and traditional risk factors were associated with metabolic syndrome.
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