Page 127 - GHES-3-1

Global Health Economics and
Sustainability
Adherence to ART among HIV patients in Cameroon

Although many strategies are needed to end the HIV/ the results will help improve the educational program
AIDS epidemic, we are certain that the epidemic will not not only for newly diagnosed PLHIV but also for health-
end without the effective use of antiretroviral treatment care staff and patients’ relatives throughout the HIV care
by those requiring it. Before antiretroviral drugs were continuum.
discovered, active medicines against HIV were unavailable.
The introduction of this highly active combination 2. Methods
therapy in 1996 dramatically altered the natural course 2.1. Setting and study period
of this infection, effectively reducing morbidity (Centers
for Disease Control and Prevention, 1996). However, We conducted this study between January and April 2024
difficulties linked to the cumbersome nature of the at the Cité des Palmiers District Hospital in Cameroon. The
treatment, multiple side effects, and compliance problems Cité des Palmiers District Hospital, located in the Littoral
emerged, compromising the success associated with region, Wouri department, and Douala V arrondissement,
antiretroviral therapy (ART). was established in 1990 as a dispensary and upgraded to
a district hospital in 1993, following a presidential decree
Adherence, which measures patient compliance creating the health districts of Cameroon. The facility
with medical prescriptions, plays an essential role in the boasts modern, well-equipped infrastructure, enabling the
effectiveness of ART (Ankri et al., 2015). It is also the main provision of advanced and emergency medical services. The
factor determining the success of ART and a fundamental medical team comprises highly qualified and experienced
element in the response to HIV infection (Moing et al., professionals who are committed to offering personalized,
2001). However, a 95% therapeutic compliance rate is quality care to every patient. They follow rigorous treatment
necessary (Mouala et al., 2006) to achieve the following protocols adapted to international standards, ensuring
therapeutic objectives: prolong life, reduce the frequency effective management of the various health conditions
of opportunistic infections, rapidly and durably stop or encountered. As a focal point for HIV/AIDS management,
slow down viral replication, and restore or improve the the Cité des Palmiers District Hospital plays a crucial role
immunity of infected individuals (Delfraissy, 2002). in HIV prevention, screening, and treatment programs as
In 2021, there were an estimated 38.4 million people well as hosts research and education initiatives aimed at
living with HIV (PLHIV) worldwide (World Health improving public health knowledge and practices.
Organization, 2022), of which 29.8 million had access
to ART (UNAIDS, 2022b) and approximately 38% had 2.2. Study design and population
poor adherence to ART as prescribed (World Health This is a quantitative, cross-sectional, descriptive, and
Organization, 2016). Africa remains the most affected analytical study that included PLHIV aged 15 – 60 years
region, with the total number of PLHIV estimated who visited the HIV care unit of the Cité des Palmiers
at approximately 25.6 million in 2021 (World Health District Hospital during the study period and signed an
Organization, 2022) and the ART coverage estimated at informed consent form for adults and an assent form for
80% (World Health Organization, 2023). In Cameroon, minors. We selected this age group because it represents a
15,000 people were newly diagnosed with HIV in 2021, period of active and productive life, during which effective
and only 78% of them were on ART (UNAIDS, 2022). management of HIV/AIDS is crucial for maintaining
Moreover, the frequency of poor adherence to treatment health and productivity and preventing the transmission
varies between 35% and 40%. (Mbopi-Kéou et al., 2012; of the virus.
Buh et al., 2023).
2.3. Sample size and procedure
To be effective, ART must be taken throughout life
with 100% compliance, as clinical and immunological The Lorenz formula was used to calculate the minimum
improvement and viral suppression are only possible sample size, assuming a precision of 5%, a 95% confidence
with treatment adherence (Mbopi-Kéou et al., 2012). interval (CI), and a prevalence value of poor adherence
Consequently, poor adherence to treatment can lead to to ART of 27.1% from previous studies (Heestermans
drug resistance and therapeutic failure (Saag et al., 2020). et al., 2016), yielding a sample size of 304. Non-probability
This study aimed to assess the factors affecting adherence convenience sampling was used as the sampling technique.
to ART among PLHIV aged 15 – 60 years at the Cité des
Palmiers District Hospital. We aim to raise awareness 2.4. Data collection techniques and tools
among PLHIV about the importance of adherence to Data were collected through a hospital-based survey
HIV prevention through health education initiatives and using a semistructured questionnaire with four headings:
promoting better self-management practices. Moreover, sociodemographic characteristics, patient-related factors,

Volume 3 Issue 1 (2025) 119 https://doi.org/10.36922/ghes.4077