Antiretroviral treatment coverage for men who have sex with men and female sex workers living with HIV in Cameroon.
BACKGROUND
Men who have sex with men (MSM) and female sex workers (FSW) are more likely to be living with HIV and experience difficulty accessing HIV health services due to stigma and discrimination. Antiretroviral treatment and sustained viral suppression among individuals living with HIV is the last step in the continuum of HIV care, which has been shown to improve health outcomes and decrease the risk of onward transmission of HIV.


METHODS
To calculate the numerator and denominator for antiretroviral therapy (ART) coverage estimates among MSM and FSW living with HIV, the Priority Locations for AIDS Control Efforts methods were modified to include individual quantitative interviews, health service assessment and mapping, and size estimation in 7 cities in Cameroon. MSM and FSW were recruited using peer referral and venue-based sampling. The numerator was calculated from interviews with MSM and FSW. Population size estimation of MSM and FSW was used to determine the denominator.


RESULTS
Antiretroviral coverage varied by site from 0% to 25% among HIV infected MSM and FSW. ART provision to the general population was reported at a significantly greater proportion of HIV health centers (56.5%) than ART provision to MSM and FSW populations (13.2%).


CONCLUSIONS
The majority of MSM and FSW living with HIV and eligible for treatment in Cameroon are not connected to ART care. Additionally, ART provision for MSM and FSW at HIV health centers is insufficient. Characterizing effective strategies to reach optimal levels of engagement in the continuum of HIV care among MSM and FSW is essential for an AIDS-free generation for Cameroon.
*Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health, Baltimore, MD; †Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon; ‡Global Viral Cameroon, Yaoundé, Cameroon; §Humanity First, Yaoundé, Cameroon; ‖Alternatives Cameroun, Douala, Cameroon; ¶Cameroon Medical Women's Association, Bamenda, Cameroon; and #CARE Cameroon, Yaoundé, Cameroon.
Claire E
CE
Holland
Erin
E
Papworth
Serge C
SC
Billong
Ubald
U
Tamoufe
Mathew
M
LeBreton
Aristide
A
Kamla
Jules
J
Eloundou
Franz
F
Managa
Yves
Y
Yomb
Pamella
P
Fokam
Honorat
H
Gbais
Iliassou
I
Mfochive
Sosthenes
S
Ketende
Stefan
S
Baral
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002163:Cameroon / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D006296:Health Services; D006297:Health Services Accessibility; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D060386:Sex Workers; D055815:Young Adult
D019380:Anti-HIV Agents