Background
The World Health Organisation under it’s “test and treat” strategy recommends same-day antiretroviral therapy (ART) initiation, after ensuring the person’s willingness and readiness to start ART. Cameroon started the implementation of this policy in 2016. Continuous monitoring of the implementation of this policy is required. We aimed at describing the trend in the prevalence of Same-day ART Initiation (SDAI) among patients enrolled in the International Epidemiology databases to Evaluate AIDS (IeDEA) study sites in Cameroon.
Method
This was a cross-sectional study of adults ≥ 21 years living with HIV enrolled in the Cameroon IeDEA from January 2000 to December 2022. Data analysis was performed using SPSS version 25.0. The proportion of patients registering for care who were initiated on ART on the day of registration (same-day), 1 to 7 days, 8-30 days and greater than 30 days was calculated per year and plotted on a trend line graph. Subgroup analysis was further stratified by gender and age.
Results
Among 13090 patients included in this study, 65.1% were female and mean age was 43 years. Trends over time showed a decrease in SDAI from 3.9% in the year 2000/2004 to 2.6% in 2015. In the year 2016, SDAI increased markedly from 3% in 2000/2004 to 52.4% in the year 2021 also, ART initiation > 30 days decreased from 94.3% in 2000/2004 to 11.1% in the year 2021 . Rapid initiation (within 7 days) over time increased from 4.3% in the year 2000/2004 to 73.8% in 2021. The overall prevalence of SDAI was higher among males than females (p<0.001).
Conclusion
Our findings suggest that time to ART initiation dropped over time and markedly after the introduction of the test and treat strategy in Cameroon in 2016, but SDAI is still below optimal. Innovative strategies to improve SDAI rates over time are urgently warranted.