Conference abstract
HIV pre-exposure prophylaxis amongst most-at-risk populations in Cameroon: Lessons learnt from the CHAMP project
Pan African Medical Journal - Conference Proceedings. 2023:17(45).04
Jun 2023.
doi: 10.11604/pamj-cp.2023.17.45.1798
Archived on: 04 Jun 2023
Contact the corresponding author
Keywords: HIV prevention, PrEP, most at-risk populations, Cameroon
Oral presentation
HIV pre-exposure prophylaxis amongst most-at-risk populations in Cameroon: Lessons learnt from the CHAMP project
Junior Jackson Nforbewing Ndenkeh1, Oscar Gayou Leyou1,&, Illiassou Mfochive Njindam2, Florent Ngueguim1, Guy Fako1, Romeo Folem1, Kelly Lepawa1, Edith Temgoua3, Zack Zeh Akiy4, David AnouarKob4, Valery Nzima4, Christine Batoum1, Sandra Georges1, William Philbrick5, Anne Bowring6, on behalf of the CHAMP team
1CARE International, Yaoundé, Cameroon, 2John Hopkins School of Public Health, Baltimore, United States, 3National AIDS Control Committee, Yaoundé, Cameroon, 4United States Agency for International Development (USAID), Yaoundé, Cameroon, 5CARE International, Atlanta, United States, 6Burnet Institute, Melbourne, Australia
&Corresponding author
Introduction: in addition to condom use, WHO recommends the use of Pre-exposure prophylaxis (PrEP) among most at-risk populations to prevent new HIV infections1, but its scale-up in low- and middle-income countries remains sub-optimal. This concept analysis seeks to understand PrEP use in the context of Cameroon.
Description: the Continuum of Prevention, care, and Treatment of HIV/AIDS with most-at-risk populations (CHAMP) project implemented in Cameroon since 2014 targets most at-risk populations for promoting HIV prevention and management. Through the CHAMP project and for the very first time, female sex workers (FSW) and men who have sex with men (MSM) who tested negative for HIV and who were assessed to be at a high risk of contracting HIV, got enrolled in the cities of Yaoundé and Douala and were offered PrEP using the daily model. Routine program data used for this analysis were collected from June 2019; when intervention began through April 2020 with which frequencies were calculated and contingency tables generated. PrEP uptake was compared between age groups and population types using a Chi-square test.
Lessons learned: overall, 11,007 beneficiaries were sensitized for PrEP, and of those, 1,539 (13.9%) underwent a PrEP eligibility assessment (FSW: 565/5,323; 11%; MSM: 974/5,684; 17%). Over 80% (1,287) of those who took the assessment were eligible to start PrEP and of those, 512 (40%); aged at least 21 years, effectively started PrEP. Despite showing less onset interest in PrEP, its uptake among eligible beneficiaries was higher among FSWs (198/429; 46%) than MSM (314/858, 37%) with a p-value of 0.0011. Of those who started PrEP, 97% continued at one month; 48% at three months; and 41% at six months. Some of the reasons for discontinuation included feeling less incentive, high mobility, and drug side effects.
Conclusion: overall, we observed low successful referrals, low PrEP uptake among eligible beneficiaries, and low PrEP continuation. The drop in PrEP continuation was highest within the first three months of PrEP. More sensitization to improve risk perception and on the benefits of PrEP may help improve interest and subsequent uptake of PrEP. There is also the need to better understand factors influencing PrEP continuation especially within the first three months to inform on PrEP continuation strategies.
HIV pre-exposure prophylaxis amongst most-at-risk populations in Cameroon: Lessons learnt from the CHAMP project
Junior Jackson Nforbewing Ndenkeh1, Oscar Gayou Leyou1,&, Illiassou Mfochive Njindam2, Florent Ngueguim1, Guy Fako1, Romeo Folem1, Kelly Lepawa1, Edith Temgoua3, Zack Zeh Akiy4, David AnouarKob4, Valery Nzima4, Christine Batoum1, Sandra Georges1, William Philbrick5, Anne Bowring6, on behalf of the CHAMP team
1CARE International, Yaoundé, Cameroon, 2John Hopkins School of Public Health, Baltimore, United States, 3National AIDS Control Committee, Yaoundé, Cameroon, 4United States Agency for International Development (USAID), Yaoundé, Cameroon, 5CARE International, Atlanta, United States, 6Burnet Institute, Melbourne, Australia
&Corresponding author
Introduction: in addition to condom use, WHO recommends the use of Pre-exposure prophylaxis (PrEP) among most at-risk populations to prevent new HIV infections1, but its scale-up in low- and middle-income countries remains sub-optimal. This concept analysis seeks to understand PrEP use in the context of Cameroon.
Description: the Continuum of Prevention, care, and Treatment of HIV/AIDS with most-at-risk populations (CHAMP) project implemented in Cameroon since 2014 targets most at-risk populations for promoting HIV prevention and management. Through the CHAMP project and for the very first time, female sex workers (FSW) and men who have sex with men (MSM) who tested negative for HIV and who were assessed to be at a high risk of contracting HIV, got enrolled in the cities of Yaoundé and Douala and were offered PrEP using the daily model. Routine program data used for this analysis were collected from June 2019; when intervention began through April 2020 with which frequencies were calculated and contingency tables generated. PrEP uptake was compared between age groups and population types using a Chi-square test.
Lessons learned: overall, 11,007 beneficiaries were sensitized for PrEP, and of those, 1,539 (13.9%) underwent a PrEP eligibility assessment (FSW: 565/5,323; 11%; MSM: 974/5,684; 17%). Over 80% (1,287) of those who took the assessment were eligible to start PrEP and of those, 512 (40%); aged at least 21 years, effectively started PrEP. Despite showing less onset interest in PrEP, its uptake among eligible beneficiaries was higher among FSWs (198/429; 46%) than MSM (314/858, 37%) with a p-value of 0.0011. Of those who started PrEP, 97% continued at one month; 48% at three months; and 41% at six months. Some of the reasons for discontinuation included feeling less incentive, high mobility, and drug side effects.
Conclusion: overall, we observed low successful referrals, low PrEP uptake among eligible beneficiaries, and low PrEP continuation. The drop in PrEP continuation was highest within the first three months of PrEP. More sensitization to improve risk perception and on the benefits of PrEP may help improve interest and subsequent uptake of PrEP. There is also the need to better understand factors influencing PrEP continuation especially within the first three months to inform on PrEP continuation strategies.
