HIV Pre-exposure Prophylaxis Uptake and Continuation Among Key Populations in Cameroon: Lessons Learned From the CHAMP Program
Pre-exposure prophylaxis (PrEP) is proven to be a highly effective HIV prevention method for key populations. However, its scale-up in resource-limited settings remains suboptimal. This paper seeks to describe PrEP initiation and continuation among key populations in Cameroon. From June 2019 through...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2022-09, Vol.91 (1), p.39-46 |
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| creator | Ndenkeh, Jackson Jr Nforbewing Bowring, Anna L. Njindam, Iliassou Mfochive Folem, Romeo Dongfack Fako, Guy Christian Hendji Ngueguim, Florent Gnintedem Gayou, Oscar Leyou Lepawa, Kelly Minka, Christine Minka Batoum, Christine Manyo Georges, Sandra Temgoua, Edith Nzima, Valery Kob, David Anouar Akiy, Zacheus Zeh Philbrick, William Levitt, Daniel Curry, Dora Baral, Stefan |
| description | Pre-exposure prophylaxis (PrEP) is proven to be a highly effective HIV prevention method for key populations. However, its scale-up in resource-limited settings remains suboptimal. This paper seeks to describe PrEP initiation and continuation among key populations in Cameroon.
From June 2019 through October 2020, we collected routine program data on PrEP uptake and continuation among female sex workers (FSWs) and men who have sex with men (MSM) in the Continuum of prevention, care and treatment of HIV/AIDS with Most-at-risk Populations (CHAMP) program in Cameroon. PrEP was offered to clients who tested negative for HIV and were assessed to potentially benefit from PrEP. Using survival analysis, we identified factors associated with PrEP discontinuation over time with significance set at 5%.
Overall, 27,750 clients were sensitized for PrEP of whom 3,138 persons were eligible to start PrEP and 1,409 (45%; FSW: 691 and MSM: 718) initiated PrEP. The PrEP continuation rate was 37% at 3 months, 28% at 6 months and 19% at 12 months. PrEP discontinuation was significantly higher among FSW than MSM [adjusted hazard ratio (aHR) 1.5 (95% CI: 1.2 to 1.9)] in Yaounde [aHR 1.5 (95% CI: 1.2 to 1.9)] and Bafoussam/Bertoua [aHR 3.1 (2.2-4.5)] relative to Douala. Discontinuation was lower among those with moderate [aHR 0.3 (0.3-0.4)] or good adherence [aHR 0.4 (0.3-0.6)] compared with poor adherence (all P < 0.001).
Differentiated approaches to deliver PrEP, create demand, and provide more intensive support for adherence and continuation may support scale-up of PrEP in Cameroon for equitable and prolonged impact on HIV prevention. |
| doi_str_mv | 10.1097/QAI.0000000000003012 |
| format | Article |
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From June 2019 through October 2020, we collected routine program data on PrEP uptake and continuation among female sex workers (FSWs) and men who have sex with men (MSM) in the Continuum of prevention, care and treatment of HIV/AIDS with Most-at-risk Populations (CHAMP) program in Cameroon. PrEP was offered to clients who tested negative for HIV and were assessed to potentially benefit from PrEP. Using survival analysis, we identified factors associated with PrEP discontinuation over time with significance set at 5%.
Overall, 27,750 clients were sensitized for PrEP of whom 3,138 persons were eligible to start PrEP and 1,409 (45%; FSW: 691 and MSM: 718) initiated PrEP. The PrEP continuation rate was 37% at 3 months, 28% at 6 months and 19% at 12 months. PrEP discontinuation was significantly higher among FSW than MSM [adjusted hazard ratio (aHR) 1.5 (95% CI: 1.2 to 1.9)] in Yaounde [aHR 1.5 (95% CI: 1.2 to 1.9)] and Bafoussam/Bertoua [aHR 3.1 (2.2-4.5)] relative to Douala. Discontinuation was lower among those with moderate [aHR 0.3 (0.3-0.4)] or good adherence [aHR 0.4 (0.3-0.6)] compared with poor adherence (all P < 0.001).
Differentiated approaches to deliver PrEP, create demand, and provide more intensive support for adherence and continuation may support scale-up of PrEP in Cameroon for equitable and prolonged impact on HIV prevention.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0000000000003012</identifier><identifier>PMID: 35536113</identifier><language>eng</language><publisher>United States: JAIDS Journal of Acquired Immune Deficiency Syndromes</publisher><subject>Acquired immune deficiency syndrome ; AIDS ; Anti-HIV Agents - therapeutic use ; Cameroon ; Clients ; Disease prevention ; Female ; HIV ; HIV Infections - drug therapy ; HIV Infections - prevention & control ; Homosexuality, Male ; Human immunodeficiency virus ; Humans ; Implementation Science ; Male ; Men ; Populations ; Pre-Exposure Prophylaxis - methods ; Prevention ; Prophylaxis ; Sex Workers ; Sexual and Gender Minorities ; Sexually transmitted diseases ; STD ; Survival analysis</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2022-09, Vol.91 (1), p.39-46</ispartof><rights>JAIDS Journal of Acquired Immune Deficiency Syndromes</rights><rights>Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4816-474205eb44242272be728cc2d2d3ad49ed24c398e601acc9bfca26c26d4262bb3</citedby><cites>FETCH-LOGICAL-c4816-474205eb44242272be728cc2d2d3ad49ed24c398e601acc9bfca26c26d4262bb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf><![CDATA[$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&PDF=y&D=ovft&AN=00126334-202209010-00006$$EPDF$$P50$$Gwolterskluwer$$H]]></linktopdf><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00126334-202209010-00006$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>230,315,782,786,887,4611,27931,27932,64673,65468</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35536113$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ndenkeh, Jackson Jr Nforbewing</creatorcontrib><creatorcontrib>Bowring, Anna L.</creatorcontrib><creatorcontrib>Njindam, Iliassou Mfochive</creatorcontrib><creatorcontrib>Folem, Romeo Dongfack</creatorcontrib><creatorcontrib>Fako, Guy Christian Hendji</creatorcontrib><creatorcontrib>Ngueguim, Florent Gnintedem</creatorcontrib><creatorcontrib>Gayou, Oscar Leyou</creatorcontrib><creatorcontrib>Lepawa, Kelly</creatorcontrib><creatorcontrib>Minka, Christine Minka</creatorcontrib><creatorcontrib>Batoum, Christine Manyo</creatorcontrib><creatorcontrib>Georges, Sandra</creatorcontrib><creatorcontrib>Temgoua, Edith</creatorcontrib><creatorcontrib>Nzima, Valery</creatorcontrib><creatorcontrib>Kob, David Anouar</creatorcontrib><creatorcontrib>Akiy, Zacheus Zeh</creatorcontrib><creatorcontrib>Philbrick, William</creatorcontrib><creatorcontrib>Levitt, Daniel</creatorcontrib><creatorcontrib>Curry, Dora</creatorcontrib><creatorcontrib>Baral, Stefan</creatorcontrib><title>HIV Pre-exposure Prophylaxis Uptake and Continuation Among Key Populations in Cameroon: Lessons Learned From the CHAMP Program</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>Pre-exposure prophylaxis (PrEP) is proven to be a highly effective HIV prevention method for key populations. However, its scale-up in resource-limited settings remains suboptimal. This paper seeks to describe PrEP initiation and continuation among key populations in Cameroon.
From June 2019 through October 2020, we collected routine program data on PrEP uptake and continuation among female sex workers (FSWs) and men who have sex with men (MSM) in the Continuum of prevention, care and treatment of HIV/AIDS with Most-at-risk Populations (CHAMP) program in Cameroon. PrEP was offered to clients who tested negative for HIV and were assessed to potentially benefit from PrEP. Using survival analysis, we identified factors associated with PrEP discontinuation over time with significance set at 5%.
Overall, 27,750 clients were sensitized for PrEP of whom 3,138 persons were eligible to start PrEP and 1,409 (45%; FSW: 691 and MSM: 718) initiated PrEP. The PrEP continuation rate was 37% at 3 months, 28% at 6 months and 19% at 12 months. PrEP discontinuation was significantly higher among FSW than MSM [adjusted hazard ratio (aHR) 1.5 (95% CI: 1.2 to 1.9)] in Yaounde [aHR 1.5 (95% CI: 1.2 to 1.9)] and Bafoussam/Bertoua [aHR 3.1 (2.2-4.5)] relative to Douala. Discontinuation was lower among those with moderate [aHR 0.3 (0.3-0.4)] or good adherence [aHR 0.4 (0.3-0.6)] compared with poor adherence (all P < 0.001).
Differentiated approaches to deliver PrEP, create demand, and provide more intensive support for adherence and continuation may support scale-up of PrEP in Cameroon for equitable and prolonged impact on HIV prevention.</description><subject>Acquired immune deficiency syndrome</subject><subject>AIDS</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Cameroon</subject><subject>Clients</subject><subject>Disease prevention</subject><subject>Female</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - prevention & control</subject><subject>Homosexuality, Male</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Implementation Science</subject><subject>Male</subject><subject>Men</subject><subject>Populations</subject><subject>Pre-Exposure Prophylaxis - methods</subject><subject>Prevention</subject><subject>Prophylaxis</subject><subject>Sex Workers</subject><subject>Sexual and Gender Minorities</subject><subject>Sexually transmitted diseases</subject><subject>STD</subject><subject>Survival analysis</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkcFu1DAQhiMEoqXwBghZ4sIlxR47zpoD0iqi3RWLWCTK1XKc2U3axE7thHYvfXaybSmlvow9_ufzjP8kecvoMaMq__hjvjymjxanDJ4lh0wJkeazmXg-7TPIUsF4dpC8ivGcUiaFUC-TA55lXDLGD5ObxfIXWQdM8br3cQw4HXxf71pz3URy1g_mAolxFSm8Gxo3mqHxjsw777bkK-7I2vdje5uMpHGkMB0G790nssIY98kVmuCwIifBd2SokRSL-bf1_pVtMN3r5MXGtBHf3Mej5Ozky89ika6-ny6L-Sq1YsZkKnIBNMNSCBAAOZSYw8xaqKDiphIKKxCWqxlKyoy1qtxYA9KCrARIKEt-lHy-4_Zj2WFl0Q3BtLoPTWfCTnvT6P9vXFPrrf-tFc9zoeQE-HAPCP5yxDjorokW29Y49GPUICVT06-yvfT9E-m5H4ObxtOQUxCKq1uguFPZ4GMMuHlohlG9N1hPBuunBk9l7x4P8lD019F_3CvfDhjiRTteYdA1mnaoJx4DyblIgQJQRRlN92jJ_wA4F7Ex</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Ndenkeh, Jackson Jr Nforbewing</creator><creator>Bowring, Anna L.</creator><creator>Njindam, Iliassou Mfochive</creator><creator>Folem, Romeo Dongfack</creator><creator>Fako, Guy Christian Hendji</creator><creator>Ngueguim, Florent Gnintedem</creator><creator>Gayou, Oscar Leyou</creator><creator>Lepawa, Kelly</creator><creator>Minka, Christine Minka</creator><creator>Batoum, Christine Manyo</creator><creator>Georges, Sandra</creator><creator>Temgoua, Edith</creator><creator>Nzima, Valery</creator><creator>Kob, David Anouar</creator><creator>Akiy, Zacheus Zeh</creator><creator>Philbrick, William</creator><creator>Levitt, Daniel</creator><creator>Curry, Dora</creator><creator>Baral, Stefan</creator><general>JAIDS Journal of Acquired Immune Deficiency Syndromes</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220901</creationdate><title>HIV Pre-exposure Prophylaxis Uptake and Continuation Among Key Populations in Cameroon: Lessons Learned From the CHAMP Program</title><author>Ndenkeh, Jackson Jr Nforbewing ; Bowring, Anna L. ; Njindam, Iliassou Mfochive ; Folem, Romeo Dongfack ; Fako, Guy Christian Hendji ; Ngueguim, Florent Gnintedem ; Gayou, Oscar Leyou ; Lepawa, Kelly ; Minka, Christine Minka ; Batoum, Christine Manyo ; Georges, Sandra ; Temgoua, Edith ; Nzima, Valery ; Kob, David Anouar ; Akiy, Zacheus Zeh ; Philbrick, William ; Levitt, Daniel ; Curry, Dora ; Baral, Stefan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4816-474205eb44242272be728cc2d2d3ad49ed24c398e601acc9bfca26c26d4262bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>AIDS</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Cameroon</topic><topic>Clients</topic><topic>Disease prevention</topic><topic>Female</topic><topic>HIV</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - prevention & control</topic><topic>Homosexuality, Male</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Implementation Science</topic><topic>Male</topic><topic>Men</topic><topic>Populations</topic><topic>Pre-Exposure Prophylaxis - methods</topic><topic>Prevention</topic><topic>Prophylaxis</topic><topic>Sex Workers</topic><topic>Sexual and Gender Minorities</topic><topic>Sexually transmitted diseases</topic><topic>STD</topic><topic>Survival analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ndenkeh, Jackson Jr Nforbewing</creatorcontrib><creatorcontrib>Bowring, Anna L.</creatorcontrib><creatorcontrib>Njindam, Iliassou Mfochive</creatorcontrib><creatorcontrib>Folem, Romeo Dongfack</creatorcontrib><creatorcontrib>Fako, Guy Christian Hendji</creatorcontrib><creatorcontrib>Ngueguim, Florent Gnintedem</creatorcontrib><creatorcontrib>Gayou, Oscar Leyou</creatorcontrib><creatorcontrib>Lepawa, Kelly</creatorcontrib><creatorcontrib>Minka, Christine Minka</creatorcontrib><creatorcontrib>Batoum, Christine Manyo</creatorcontrib><creatorcontrib>Georges, Sandra</creatorcontrib><creatorcontrib>Temgoua, Edith</creatorcontrib><creatorcontrib>Nzima, Valery</creatorcontrib><creatorcontrib>Kob, David Anouar</creatorcontrib><creatorcontrib>Akiy, Zacheus Zeh</creatorcontrib><creatorcontrib>Philbrick, William</creatorcontrib><creatorcontrib>Levitt, Daniel</creatorcontrib><creatorcontrib>Curry, Dora</creatorcontrib><creatorcontrib>Baral, Stefan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ndenkeh, Jackson Jr Nforbewing</au><au>Bowring, Anna L.</au><au>Njindam, Iliassou Mfochive</au><au>Folem, Romeo Dongfack</au><au>Fako, Guy Christian Hendji</au><au>Ngueguim, Florent Gnintedem</au><au>Gayou, Oscar Leyou</au><au>Lepawa, Kelly</au><au>Minka, Christine Minka</au><au>Batoum, Christine Manyo</au><au>Georges, Sandra</au><au>Temgoua, Edith</au><au>Nzima, Valery</au><au>Kob, David Anouar</au><au>Akiy, Zacheus Zeh</au><au>Philbrick, William</au><au>Levitt, Daniel</au><au>Curry, Dora</au><au>Baral, Stefan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HIV Pre-exposure Prophylaxis Uptake and Continuation Among Key Populations in Cameroon: Lessons Learned From the CHAMP Program</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2022-09-01</date><risdate>2022</risdate><volume>91</volume><issue>1</issue><spage>39</spage><epage>46</epage><pages>39-46</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><abstract>Pre-exposure prophylaxis (PrEP) is proven to be a highly effective HIV prevention method for key populations. However, its scale-up in resource-limited settings remains suboptimal. This paper seeks to describe PrEP initiation and continuation among key populations in Cameroon.
From June 2019 through October 2020, we collected routine program data on PrEP uptake and continuation among female sex workers (FSWs) and men who have sex with men (MSM) in the Continuum of prevention, care and treatment of HIV/AIDS with Most-at-risk Populations (CHAMP) program in Cameroon. PrEP was offered to clients who tested negative for HIV and were assessed to potentially benefit from PrEP. Using survival analysis, we identified factors associated with PrEP discontinuation over time with significance set at 5%.
Overall, 27,750 clients were sensitized for PrEP of whom 3,138 persons were eligible to start PrEP and 1,409 (45%; FSW: 691 and MSM: 718) initiated PrEP. The PrEP continuation rate was 37% at 3 months, 28% at 6 months and 19% at 12 months. PrEP discontinuation was significantly higher among FSW than MSM [adjusted hazard ratio (aHR) 1.5 (95% CI: 1.2 to 1.9)] in Yaounde [aHR 1.5 (95% CI: 1.2 to 1.9)] and Bafoussam/Bertoua [aHR 3.1 (2.2-4.5)] relative to Douala. Discontinuation was lower among those with moderate [aHR 0.3 (0.3-0.4)] or good adherence [aHR 0.4 (0.3-0.6)] compared with poor adherence (all P < 0.001).
Differentiated approaches to deliver PrEP, create demand, and provide more intensive support for adherence and continuation may support scale-up of PrEP in Cameroon for equitable and prolonged impact on HIV prevention.</abstract><cop>United States</cop><pub>JAIDS Journal of Acquired Immune Deficiency Syndromes</pub><pmid>35536113</pmid><doi>10.1097/QAI.0000000000003012</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1525-4135 |
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| language | eng |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; Free E- Journals |
| subjects | Acquired immune deficiency syndrome AIDS Anti-HIV Agents - therapeutic use Cameroon Clients Disease prevention Female HIV HIV Infections - drug therapy HIV Infections - prevention & control Homosexuality, Male Human immunodeficiency virus Humans Implementation Science Male Men Populations Pre-Exposure Prophylaxis - methods Prevention Prophylaxis Sex Workers Sexual and Gender Minorities Sexually transmitted diseases STD Survival analysis |
| title | HIV Pre-exposure Prophylaxis Uptake and Continuation Among Key Populations in Cameroon: Lessons Learned From the CHAMP Program |
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