title: Epidemiology of human immunodeficiency virus-1 and hepatitis B virus co-infection and risk factors for acquiring these infections in the Fako division of Southwest Cameroon.
abstract: BACKGROUND
  Past studies have demonstrated that a large population of Cameroonians are afflicted with human immunodeficiency virus (HIV) and/or hepatitis B virus (HBV) demonstrating a need for better prevention programs. We aim to describe the prevalence of HIV, HBV and HIV/HBV co-infection; examine the association between HIV and HBV; and determine risk correlates associated with HIV and HBV transmission in Southwest Cameroon.
  
  
  METHODS
  A cross-sectional, community-based surveillance study was conducted among adults in five hospitals , one in each of the five health districts of the Fako division of the Southwest region of Cameroon. Participants underwent pre- and post-test counselling, a 30-question survey and blood draw for HIV and HBV serologic testing. To construct a final model, chi-squared tests and logistic regression were used to investigate associations.
  
  
  RESULTS
  Among 761 participants, 40.32 % were male, mean age was 35.21 ± 12.42 years, and the prevalence of HIV, HBV and HIV/HBV co-infection was 10.69 % , 9.86 % , and 1.16 % , respectively. There was no association between HIV and HBV infection. However, there was a statistically significant crude associated (p-value < 0.05) between HIV and three high-risk sexual behaviour variables: condom use, number of lifetime sexual partners, and age at first sexual intercourse. After adjustment, HIV status continued to be associated with number of lifetime sexual partners (adjusted odds ratio (AOR) = 2.26; 95 % confidence interval (CI) =1.22-4.17) and age at first sexual intercourse (AOR = 2.63; 95 % CI =1.44-4.81). In contrast, none of the high-risk sexual behaviours was associated with HBV.
  
  
  CONCLUSIONS
  The prevalence of HIV and HBV was relatively high in the Southwest region of Cameroon, emphasizing the importance of intervention and treatment programs in this country. Additionally, the results from this study suggest that unlike HIV, HBV is not associated with sexual risk factors and may provide evidence that HBV is acquired through routes other than sexual transmission, warranting further investigation in this region.
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA. lauren.shevell@gmail.com.
authors.forename: Lauren
authors.initials: L
authors.lastname: Shevell
authors.affiliation: Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon. merilonga@yahoo.com.
authors.forename: Henry Dilonga
authors.initials: HD
authors.lastname: Meriki
authors.affiliation: Department of Biochemistry and Microbiology, University of Buea, Buea, Cameroon. chongwa_ub@yahoo.co.uk.
authors.forename: Fidelis
authors.initials: F
authors.lastname: Cho-Ngwa
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA. cf317@columbia.edu.
authors.forename: Crystal
authors.initials: C
authors.lastname: Fuller
mesh_terms: D000293:Adolescent; D000328:Adult; D002163:Cameroon / Q000453:epidemiology; D060085:Coinfection / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D015497:HIV-1; D006306:Health Surveys; D006509:Hepatitis B / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D055815:Young Adult