Background:
HIV/AIDS remains a major public health challenge across sub-Saharan Africa. Community-Based Organisations (CBOs) are increasingly recognised for their effort to strengthen HIV case finding and long-term management of people living with HIV/AIDS (PLWHA), particularly in conflict-affected settings. However, evidence remains limited regarding both the benefits and challenges of CBO-led HIV service delivery.
Objective:
To examine the role of CBOs in HIV/AIDS case finding and management in the North-West Region of Cameroon.
Methods:
A mixed-methods study was conducted from April to June 2022. Retrospective quantitative data from 10 CBOs for the year 2021 were extracted from registers, DAMA reports, and linkage forms to assess HIV case-finding and linkage-to-care indicators. In addition, primary qualitative data were generated through semi-structured interviews with 15 PLWHA. Quantitative data were analysed descriptively using SPSS version 26, while qualitative data were analysed thematically.
Results:
CBOs identified a total of 310 new HIV-positive cases through multiple strategies, including index testing (105), drop-in centres (91), medicine stores (72), door-to-door testing (23), and other approaches (19). Additionally, 105 clients previously lost to follow-up were successfully re-engaged in care. PLWHA described several benefits of CBO-led differentiated service delivery, including reduced travel burden, improved adherence support, psychosocial counselling, nutritional guidance, tuberculosis screening, and facilitated viral load sample collection. However, participants also highlighted key challenges, including persistent HIV-related stigma within communities, concerns about confidentiality, inconsistent availability of nutritional support, and variability in the quality and continuity of services across CBOs.
Conclusion:
CBOs play a critical role in HIV case finding and continuity of care for PLWHA in the North-West Region of Cameroon. While CBO-led services could enhance access and retention in care, addressing identified challenges related to stigma, confidentiality, and service consistency is essential to maximise their impact and strengthen community-based HIV service delivery.