Factors associated with risk of HIV-infection among pregnant women in Cameroon: Evidence from the 2016 national sentinel surveillance survey of HIV and syphilis

PLoS One. 2019 Apr 12;14(4):e0208963. doi: 10.1371/journal.pone.0208963. eCollection 2019.

Abstract

Background: Human Immunodeficiency Virus infection (HIV) remains a public health concern in Cameroon that requires regular surveillance for informed policy-making to guide programmatic interventions. Using data from the 2016 HIV national sentinel survey in Cameroon, we ascertained HIV prevalence and factors associated with risk of infection among pregnant women.

Methods: A cross-sectional study was conducted throughout 2016 in the 10 regions of Cameroon, targeting 7000 first antenatal care (ANC-1) attendees (4000 from urban and 3000 from rural areas) in 60 sentinel health facilities. HIV serological test was performed using the national serial algorithm at the National Reference Laboratory (NRL). Prevalence was determined, and multivariate logistic regression was used to assess determinants of HIV infection, with p-value<0.05 considered statistically significant.

Results: Of the 7000 targeted participants, a total of 6859 first ANC-1 attendees were enrolled (98.0% sampling coverage). Median age was 26 [IQR: 21-30] years and 47,40% had a secondary school level of education. The national prevalence of HIV was 5.70% (95% CI: 4.93-6.40) and range from 9.7% in East region to 2.6% in North region. The prevalence was 5.58% (95% CI: 95%: 4.88-6.35) in urban and 5.87% (95% CI: 5.04-6.78) in rural settings. Factors that were associated with HIV infection included marital status, women who were married or living with their partner are less likely to be infected than singles women (aOR = 0.60; 95% CI: 0.46-0.78), multiparity [aOR = 1.5(95%CI:1.0-2.2)] and been living in the Centre, East, North-west and South-west regions. HIV infection was also significantly associated with age, with the risk of being infected increasing with age.

Conclusion: Pregnant women in Cameroon are still disproportionately infected with HIV compared with the general population (prevalence 4.3%). Preventive actions to curb the epidemic amongst pregnant women should prioritize interventions targeting single pregnant women, who are older, and residing particularly in the Centre, East, North West and South West regions of the country.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Cameroon / epidemiology
  • Cross-Sectional Studies
  • Female
  • HIV Infections / epidemiology*
  • Humans
  • Marital Status
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology*
  • Prevalence
  • Risk Factors
  • Rural Population
  • Sentinel Surveillance
  • Syphilis / epidemiology*
  • Young Adult

Grants and funding

This study was funded by the Global Fund to fight AIds, tuberculosis and malaria(https://www.theglobalfund.org). The Ministry of public Health was the PI of the funds and JF received consultancy honorarium for the sentinel survey. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.