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Evaluating the effectiveness of oral HIV self testing according to distribution models in Cameroon

Article scientifique 2024 Anglais

Résumé

Innovative strategies such as HIV self-testing (HIVST) are useful for identifying hard-to-reach people living with HIV/AIDS (PLHIV), especially in developing settings where considerable gaps still exist in reaching the first 95% UNAIDS target. We evaluated the effectiveness of HIVST in Cameroon using several distribution models and investigated the predictors of HIV seropositivity among self-testers. The study was conducted from 2021 to 2022 in three regions in Cameroon. HIVST kits were distributed according to 5 distribution models: antenatal, postnatal, maternal and child clinics (ANC/PNC/MCH); partners of PLHIV; workplace; community and HIV-testing services (HTS). Overall, 42,687 people received oral HIVST kits, among whom 15.6% were HIV first-testers. Approximately 85% reported on the test outcome; 2.3% (n = 825) were reactive, and 75.8% came for test confirmation. After the confirmation test, a concordance of 85% was found with the national algorithm. Overall, the HIV seroprevalence was 1.5% [95% CI: 1.4-1.6]; ANC/PNC/MCHC: 1.9%, partners of PLHIV: 6.9%, workplace: 0.5%, community: 0.1% and HTS: 7.0%, p < 0.001. The positivity rate among first-testers was 1.2%. Youths < 25 years had a lower seroprevalence (0.4%) than older people (2.6% and 2.7% for those aged 25-39 and those aged ≥ 40 years, respectively), p < 0.001. Seropositivity was negatively associated with secondary distribution, workplace model, community model and age < 25 years. On the other hand, partners of PLHIV model, HTS model, female sex and first-time-testers were positively associated with seropositivity. In Cameroon, oral HIVST is an effective approach for identifying undiagnosed PLHIV, especially when using ANC/PNC/MCHC, partners of PLHIV and HTS distribution models. However, to ensure the successful scale-up of HIVST in Cameroon, guidelines should be revised to fine-tune the target populations for HIVST and optimize the use of resources.

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Bouba, Y., Djomo, A., Mouliom, F., Souleymanou, A., Lifanda, E., Liman, Y., Onana, R., Salla, A., Ekobika, L., Tchikangni, G., Omona, E., Myrtho, I., Mvilongo, E., Socpa, A., Ajeh, R., Essi, M., Billong, S., Hamsatou, H., Bissek, A. (2024). Evaluating the effectiveness of oral HIV self testing according to distribution models in Cameroon. https://doi.org/10.1038/s41598-024-78444-w

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Auteur(s)

Yagaï Bouba Audrey Raissa Dzaddi Djomo Fatima Nkain Mouliom Adamou Souleymanou Ebiama Lifanda Yakouba Liman Roger Martin Onana Annie Michele Salla Lily Claire Ekobika Gutenberg Tchikangni Edwige Guissana Omona Ingrid Kenko Abo’o Myrtho Ernest Désiré Anaba Mvilongo Antoine Socpa Rogers Ajeh Marie José Essi Serge Clotaire Billong Hadja Cherif Hamsatou Anne Cécile Zoung-Kanyi Bissek

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