Time to Antiretroviral Treatment Initiation and Factors associated to Same Day Initiation in the West Region of Cameroon

Abstract

Same-day Antiretroviral Treatment (ART) initiation after a positive HIV test result is vital for faster viral suppression. This study assessed the time to ART initiation and factors associated to SDAI in the West region of Cameroon. This was a cross-sectional retrospective study. The data was extracted from registers and patients’ medical records and analysed. The mean age of the 3053 participants was 36.9 (SD: 13.3), and 64.0% were female. A total of 2346 (76.8%) participants had initiated ART the same day of the diagnosis. Female gender (OR= 1.2; 95%CI:1.1-1.5), Tier 3 HF (OR= 1.3; 95%CI: 1-1.7), semi-urban facility’s location (OR= 1.4; 95%CI: 1.1-1.7), periods of test January-March 2020 (OR= 2; 95%CI: 1.6-2.6), April- June 2020 (OR= 1.7; 95%CI: 1.3-2.2), and July- September 2020 (OR= 3.4; 95%CI: 2.5-4.6), index case testing entry point (OR= 1.6; 95%CI: 1.2-2.1), active occupational situation (OR= 1.3; 95%CI: 1-1.7), and good general status (OR= 1.3; 95%CI: 1.1-1.6) were independently associated to same day initiation. In addition to WHO stage 2 (OR= 0.6; 95%), tuberculosis (OR= 0.2; 95%CI: 0.1-0.5), inpatient (OR= 0.2; 95%CI: 0.1-0.4) and emergency entry point (OR= 0.1; 95%CI: 0-0.2) were inversely associated to SDI. The ART initiation was timely for most clients in the West region of Cameroon, in alignment with the WHO recommendations. However, this was not the case among symptomatic, critically ill, and tuberculosis clients. This underscores the need for ongoing support, counselling, and continuous readiness assessment, as well as a strong linkage system for clients with delayed ART initiation.