LOSS TO FOLLOW-UP AMONG CHILDREN AND ADOLESCENTS ATTENDING ART CLINICS IN THE CONTEXT OF SOCIO-POLITICAL CRISES IN THE NORTHWEST AND SOUTHWEST REGIONS OF CAMEROON (2018-2021): THE CAREGIVER’S PERSPECTIVES.
Charlotte Wenze Ayima1, Eveline Mboh Khan1,2 and Pius Muffih Tih3
Background
Loss to follow-up(LTFU) among HIV positive children and adolescents greatly contributes to sub-optimal retention in HIV prevention and treatment program outcomes. This can be worse among conflict affected areas of the country. LTFU threatens efforts to ensure longevity and survival of children and adolescents living with HIV(CALHIV). In the context of the ongoing socio-political crises and instability in the Northwest and Southwest Regions of Cameroon, we investigated reasons for LTFU among children and adolescents enrolled on ART.
Methods
We conducted a qualitative study, nested within a larger cohort study (2018-2021) on assessing the incidence of LTFU among children and adolescents in the two regions of Cameroon. Data collection was done from November 2021 to January 2022. Electronic database and files of CALHIV who were LTFU was assessed from which we traced and interviewed 25 caregivers of children/ adolescents LTFU. Recorded interviews were transcribed, translated and analyzed using Atlas.ti Version 9.
Results
The following themes emerged as the main reasons of LTFU:Socio-political crises/displacement, long distances/cost of transportation, lack of partner/family support, refusal/dating/marriage among adolescents, poverty/competitive life activities, stigma, shortage of ARVs/poor efficacy, alternative forms of health care and negative attitudes of healthcare providers.
Conclusion
Our study found multiple factors at personal, family, community, and health system levels, which contributed to poor retention in children and adolescents on ART.Displacement of caregivers coupled with constant roadblocks to health facilities was the main reason for poor retention in CALHIV.The impact of the sociopolitical crisis on HIV services therefore, cannot be neglected.There is an urgent need for contingency plans, preparedness measures and policies for HIV management in the conflict-affected regions in Cameroon.