ART uptake and early retention among pregnant women screened HIV infected in informal health centers in Cameroon

Informal health centers are booming in Cameroon and are utilized by a
large part of the population. Most of these IHCs have antenatal care
services (ANC) and screen pregnant women for HIV.  This dataset
was collected in informal health centers in two cities in Cameroon: Douala
and Yaounde. This dataset aimed at firstly, investigate the initiation of
Antiretroviral therapy (ART) in pregnant women screened positive for HIV
in antenatal care services of IHCs, three months after HIV screening as
well as their retention at 3 months post-initiation. Secondly, study the
association between this intiation and retention with type of PMTCT site
or model of care ( IHCs that offered integrated ANC and ART, VS those that
required referral to HIV care centers). Third, identifying associated
factors to ART non-initiation in this population. From January 2018 to
July 2020, we carried out a cohort study of pregnant women attending their
first ANC and screened HIV positive at IHCs in
Cameroon. Consenting participants  were interviewed at
three points: the day of the delivery of the antenatal HIV test result, 3
months later and three months after ART initiation, using anonymous
standardized questionnaires. The data collected were entered into Kobo
collect and analyzed in SPSS V23.0 software. Descriptive statistics were
performed. Frequencies and percentage for categorical variables; median
and interquartile ranges for continuous variables. Proportions were used
to calculate ART coverage and retention. Chi-square was used to compare
the proportions of initiation of ART and retention between group of women
screened in IHCs without ART and those screened in IHCs with ART
integrated in antenatal care service. Logistic regression was used to
identify factors associated to ART non-initiation at 95% confidence
interval. Baseline variables were initially analyzed univariately and
those which were significant at the level of 5% were retained for
multivariable logistic regression. Baseline variables used for this
purpose were type of PMTCT site, age group, study level, income generating
activity, income generating activity of partner, relationship duration,
Primiparity, Pregnancy willingness, perceived self-efficacy of being able
to initiate ART. A total of 182 pregnant women living with HIV were
enrolled in the study. At the first ANC, 91% (166/182) were naïve of ART.
Among them, only 45% (74/166) initiated ART and 65% (48/74) of them were
retained in ART 3 months later. PWLHIV screened in IHCs with no ART (aOR =
14.07, 95%CI: 4.68-42.32, p<0.001) and those who doubted their
perceived capacity to initiate ART (aOR= 15.43, 95% CI: 4.45 to 53.44,
p< 0.001) were more likely to not initiate ART Given the low
enrollment in ART among pregnant women living with HIV, screened in
informal health centers, and the early low retention among those who
initiated ART, greater attention in PMTCT policies in Cameroon should be
given to pregnant women screened positive for HIV during ANC in informal
health centers, in order to guarantee them a continuum of PMTCT care.