Bouba Yagai, Djomo Audrey Raissa Dzaddi, Mouliom Fatima Nkain, Souleymanou Adamou, Lifanda Ebiama, Liman Yakouba, Onana Roger, Salla Annie Michele, Ekobika Lily Claire, Tchikangni Gutenberg, Omona Edwige Guissana, Myrtho Ingrid Kenko Abo'o, Mvilongo Ernest Désiré Anaba, Socpa Antoine, Ajeh Rogers Awoh, Essi Marie Jose, Billong Serge Clotaire, Hamsatou Hadja Cherif, Bissek Anne Cecile Zoung-Kanyi
UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy.
Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon.
Sci Rep. 2024 Dec 28;14(1):30694. doi: 10.1038/s41598-024-78444-w.
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.
诸如艾滋病毒自我检测（HIVST）等创新策略有助于识别难以接触到的艾滋病毒/艾滋病感染者（PLHIV），尤其是在发展中地区，在实现联合国艾滋病规划署首个95%目标方面仍存在相当大差距的情况下。我们在喀麦隆评估了使用几种分发模式的HIVST的有效性，并调查了自我检测者中艾滋病毒血清阳性的预测因素。该研究于2021年至2022年在喀麦隆的三个地区进行。HIVST检测试剂盒根据5种分发模式进行分发：产前、产后、母婴诊所（ANC/PNC/MCH）；PLHIV的性伴侣；工作场所；社区和艾滋病毒检测服务（HTS）。总体而言，42687人领取了口服HIVST检测试剂盒，其中15.6%是首次进行艾滋病毒检测者。约85%的人报告了检测结果；2.3%（n = 825）呈反应性，75.8%前来进行检测确认。确认检测后，与国家算法的一致性为85%。总体而言，艾滋病毒血清流行率为1.5%[95%置信区间：1.4 - 1.6]；ANC/PNC/MCHC：1.9%，PLHIV的性伴侣：6.9%，工作场所：0.5%，社区：0.1%，HTS：7.0%，p < 0.001。首次检测者中的阳性率为1.2%。年龄小于25岁的年轻人血清流行率（0.4%）低于老年人（25 - 39岁者为2.6%，40岁及以上者为2.7%），p < 0.001。血清阳性与二次分发、工作场所模式、社区模式以及年龄小于25岁呈负相关。另一方面，PLHIV的性伴侣模式、HTS模式、女性性别和首次检测者与血清阳性呈正相关。在喀麦隆，口服HIVST是识别未被诊断的PLHIV的有效方法，尤其是在使用ANC/PNC/MCHC、PLHIV的性伴侣和HTS分发模式时。然而，为确保HIVST在喀麦隆成功扩大规模，应修订指南，以微调HIVST的目标人群并优化资源利用。
