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
Hauptverfasser: 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
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container_issue 1
container_start_page 39
container_title Journal of acquired immune deficiency syndromes (1999)
container_volume 91
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.
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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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