Conference abstract
Sustained improvements in linkage to treatment among key populations in Cameroon
Pan African Medical Journal - Conference Proceedings. 2023:17(72).04
Jun 2023.
doi: 10.11604/pamj-cp.2023.17.72.1795
Archived on: 04 Jun 2023
Contact the corresponding author
Keywords: Key population, Linkage, antiretroviral therapy, Cameroon
Poster
Sustained improvements in linkage to treatment among key populations in Cameroon
Anna Bowring1,2, Christine Sarah Minka Minka3,&, Ghislaine Fouda3, Florent Ngueguim Gnintedem3, Iliassou Mfochive Njindam1,4, Guy Fako4, David Anouar Kob Ye Sam5, Zachaeus Zeh Akiy5, Ubald Tamoufe4,6, Stefan Baral1, Sandra Georges3, Daniel Levitt7, Serge Clotaire Billong8,9, Anne Cécile Zoung-Kanyi Bissek9,10
1Johns Hopkins School of Public Health, Department of Epidemiology, Baltimore, United States, 2Burnet Institute, Melbourne, Australia, 3CARE Cameroon, Yaoundé, Cameroon, 4Metabiota, Yaoundé, Cameroon, 5USAID, Yaoundé, Cameroon, 6Johns Hopkins Cameroon, Yaoundé, Cameroon, 7CARE USA, Atlanta, United States, 8Groupe Technique Central, National AIDS Control Committee (CNLS), Yaoundé, Cameroon, 9University of Yaoundé I, Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon, 10Ministry of Health, Department of Operational Research, Yaoundé, Cameroon
&Corresponding author
Introduction: in Cameroon female sex workers (FSW) and men who have sex with men (MSM) have a high burden of HIV. Barriers to accessing HIV services include stigma, discrimination, violence, long waiting times, user fees, and population mobility.
Methods: under the ‘Continuum of prevention, care and treatment of HIV/AIDS with Most-at-risk Populations’ (CHAMP) program, community-based organisations (CBOs) in three cities have provided peer-driven HIV services since 2014. Initiation on antiretroviral therapy (ART) is predominantly provided to new clients through HIV treatment health facilities. HIV testing and linkage to ART data were electronically collected. Aggregate data on diagnoses and linkage to ART were analysed by fiscal year (FY) and key population (KP) from October 2014-September 2019.
Results: prior to national ‘Test & Treat’ guidelines, introduced early 2017, linkage to ART was 31% (297/948) among FSW and 57% (216/379) among MSM in FY16. Linkage to ART increased to 72% (740/1,033) among FSW and 68% (345/511) among MSM in FY17 but remained below targets. Innovations to support linkage to ART were scaled in FY18, and linkage increased to 93% (1,264/1,359) and 95% (709/747), respectively. High linkage was maintained in FY19 among FSW (95%; 1,688/1,777) and MSM (96%; 790/819). Key initiatives heading this success were: active referral for same-day initiation or arranged appointments by strengthening the role of peer navigator; sensitizing focal points at treatment centres on KPs’ needs; involving peer navigators and clinicians during outreach testing; piloting on-site initiation; performance-based management; and weekly follow-up by case management teams. Additionally, during FY18 psychosocial counsellors and peer navigators were trained to use motivational interviewing, and during FY19 extended opening hours were arranged at selected treatment centres.
Conclusion: combined strategies involving active referral, coordinated and patient-centred support by peer workers, psychosocial counsellors and clinicians, and collaboration between community-based and national health facilities led to sustained improvements in linkage to ART. These approaches are likely to also support retention on ART and should be considered for widespread implementation.
Sustained improvements in linkage to treatment among key populations in Cameroon
Anna Bowring1,2, Christine Sarah Minka Minka3,&, Ghislaine Fouda3, Florent Ngueguim Gnintedem3, Iliassou Mfochive Njindam1,4, Guy Fako4, David Anouar Kob Ye Sam5, Zachaeus Zeh Akiy5, Ubald Tamoufe4,6, Stefan Baral1, Sandra Georges3, Daniel Levitt7, Serge Clotaire Billong8,9, Anne Cécile Zoung-Kanyi Bissek9,10
1Johns Hopkins School of Public Health, Department of Epidemiology, Baltimore, United States, 2Burnet Institute, Melbourne, Australia, 3CARE Cameroon, Yaoundé, Cameroon, 4Metabiota, Yaoundé, Cameroon, 5USAID, Yaoundé, Cameroon, 6Johns Hopkins Cameroon, Yaoundé, Cameroon, 7CARE USA, Atlanta, United States, 8Groupe Technique Central, National AIDS Control Committee (CNLS), Yaoundé, Cameroon, 9University of Yaoundé I, Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon, 10Ministry of Health, Department of Operational Research, Yaoundé, Cameroon
&Corresponding author
Introduction: in Cameroon female sex workers (FSW) and men who have sex with men (MSM) have a high burden of HIV. Barriers to accessing HIV services include stigma, discrimination, violence, long waiting times, user fees, and population mobility.
Methods: under the ‘Continuum of prevention, care and treatment of HIV/AIDS with Most-at-risk Populations’ (CHAMP) program, community-based organisations (CBOs) in three cities have provided peer-driven HIV services since 2014. Initiation on antiretroviral therapy (ART) is predominantly provided to new clients through HIV treatment health facilities. HIV testing and linkage to ART data were electronically collected. Aggregate data on diagnoses and linkage to ART were analysed by fiscal year (FY) and key population (KP) from October 2014-September 2019.
Results: prior to national ‘Test & Treat’ guidelines, introduced early 2017, linkage to ART was 31% (297/948) among FSW and 57% (216/379) among MSM in FY16. Linkage to ART increased to 72% (740/1,033) among FSW and 68% (345/511) among MSM in FY17 but remained below targets. Innovations to support linkage to ART were scaled in FY18, and linkage increased to 93% (1,264/1,359) and 95% (709/747), respectively. High linkage was maintained in FY19 among FSW (95%; 1,688/1,777) and MSM (96%; 790/819). Key initiatives heading this success were: active referral for same-day initiation or arranged appointments by strengthening the role of peer navigator; sensitizing focal points at treatment centres on KPs’ needs; involving peer navigators and clinicians during outreach testing; piloting on-site initiation; performance-based management; and weekly follow-up by case management teams. Additionally, during FY18 psychosocial counsellors and peer navigators were trained to use motivational interviewing, and during FY19 extended opening hours were arranged at selected treatment centres.
Conclusion: combined strategies involving active referral, coordinated and patient-centred support by peer workers, psychosocial counsellors and clinicians, and collaboration between community-based and national health facilities led to sustained improvements in linkage to ART. These approaches are likely to also support retention on ART and should be considered for widespread implementation.
