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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Factors associated with late antiretroviral therapy initiation in cameroon: A representative multilevel analysis
Journal of Antimicrobial Chemotherapy, Volume 68, No. 6, Year 2013
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Description
Objectives: Many people living with HIV/AIDS in resource-limited settings begin antiretroviral therapy (ART) at low CD4 counts. Here, we investigated the simultaneous effect of individual-, facility- and regional-level factors on late ART initiation. Methods: We conducted a survey in a nationally representative sample of 55 HIV treatment facilities in Cameroon. Medical records of 4935 patients >15 years of age who initiated ART in the month of October during the period 2007-10 were reviewed to gather individual characteristics. Late ART initiation was defined as CD4 count≤100 cells/mm3. Facility- and regional-level characteristics were also collected. Two-level regression logistic models were used to identify factors associated with late ART initiation. Results: Late ART initiation was associated with being a male younger than 45 years versus female younger than 45 years [adjusted OR (AOR)=1.5, 95% CI: 1.3-1.7] and initiating ART in the period 2007-09 versus 2010 (AOR=1.2, 95% CI: 1.0-1.4). Late initiation was more likely in central than in district hospitals (AOR=1.3, 95% CI: 1.1-1.6) and in hospitals without a mother-to-child transmission programme (AOR=1.9, 95% CI: 1.3-2.8). Living in a region with a higher comprehensive knowledge of HIV/AIDS was associated with not initiating ART late (AOR=0.8, 95% CI: 0.6-1.0). Conclusions: This study shows that risk factors associated with late ART initiation operate at multiple levels and that multilevel interventions are therefore necessary to promote earlier HIV testing and treatment ©The Author 2013. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Authors & Co-Authors
Ndawinz, Jacques D.A.
France, Paris
Sorbonne Université
France, Paris
Inserm
Chaix, Basile
France, Paris
Sorbonne Université
France, Paris
Inserm
Koulla-Shiro, Sinata
Cameroon, Yaounde
Central Hospital of Yaounde Fmbs
Delaporte, Éric
France, Montpellier
Ird Centre de Montpellier
Okouda, Barnabe
Cameroon, Yaounde
National Institute of Statistics
Abanda, Ambroise
Cameroon, Yaounde
National Institute of Statistics
Tchomthe, Severin
Cameroon, Yaounde
National Institute of Statistics
Mboui, Etienne
Cameroon, Yaounde
National Aids Control Committee
Costagliola, Dominique G.
France, Paris
Sorbonne Université
France, Paris
Inserm
France, Paris
Ap-hp Assistance Publique - Hopitaux de Paris
Supervie, Virginie
France, Paris
Sorbonne Université
France, Paris
Inserm
Statistics
Citations: 30
Authors: 10
Affiliations: 7
Identifiers
Doi:
10.1093/jac/dkt011
ISSN:
03057453
e-ISSN:
14602091
Research Areas
Cancer
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Cameroon
Participants Gender
Male
Female