Research for Health Care and Policy on HIV/AIDS: proceedings of the third edition of the Cameroon HIV Research (CAM-HERO) 2022, Kribi, Cameroon, from 1st to 3rd December 2022.

Cameroon is committed to reaching HIV epidemic control through coordinated efforts by the Ministry of Public Health, the National AIDS Control Committee, bilateral/multilateral institutions and implementing partners. The third edition of the Cameroon HIV Research Forum (CAM-HERO) was held in Kribi from December 1st to 3rd, 2022, with the theme "Research for Health Care and Policy on HIV/AIDS." The conference brought together local and international scientists and clinicians, policymakers, and regulatory authorities to 1) disseminate HIV research findings and HIV policy; 2) foster operational research collaboration; 3) build research capacity through training on basics of research methods and CAM-HERO young investigator Awards; and 4) initiate a guideline for promoting HIV/AIDS research in Cameroon. The main activities included training on research methodology and basic principles in bioethics, presentations of selected abstracts, and awards for top research. A total of 35 abstracts (16 oral presentations, 16 posters, and 3 late-breaker-abstracts) were selected for presentation following a rigorous review. The conference ended with evidence-based recommendations and a way-forward statement for the development of a National Guide for HIV/AIDS research in Cameroon, with the aim of improving the quality and quantity of research agenda and projects nationwide.

Improving Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) Treatment Monitoring in South Africa: Evaluation of an Advanced TB/HIV Course for Healthcare Workers.

BACKGROUND: South Africa has dual epidemics of human immunodeficiency virus (HIV) and tuberculosis (TB). Nurse-focused training was combined with onsite mentoring for nurses to improve HIV and TB care. A pre-/postevaluation was conducted in 3 districts in South Africa to assess the effects of the course on clinical patient monitoring and integration of TB and HIV care. METHODS: Two cross-sectional, unmatched samples of patient charts at 76 primary healthcare facilities were collected retrospectively in 2014 to evaluate the impact of training on treatment monitoring. Proportions of HIV patients receiving a viral load test 6 months after initiating antiretroviral therapy (ART) and TB patients receiving end of intensive phase sputum testing were compared pre- and posttraining. Analysis of creatinine clearance testing and integration of TB and HIV care were also performed. RESULTS: Data were analyzed from 1074 pretraining and 1048 posttraining records among patients initiating ART and from 1063 pretraining and 1008 posttraining among patients initiating TB treatment. Documentation of a 6-month viral load test was 36.3%, and a TB test at end of intensive phase was 70.7%, and neither increased after training. Among patients with a viral load test, the percentage with viral load less than 50 copies/mL increased from 48.6% pretraining compared with 64.2% posttraining (P = .001). Integration of TB and HIV care such as isoniazid preventive therapy increased significantly. CONCLUSIONS: The primary outcome measures did not change after training. However, the evaluation documented many other improvements in TB and HIV care that may have been supported by the course.

Breastfeeding: the hidden barrier in Côte d'Ivoire's quest to eliminate mother-to-child transmission of HIV.

INTRODUCTION: Côte d'Ivoire has one of the worst HIV/AIDS epidemics in West Africa. This study sought to understand how HIV-positive women's life circumstances and interactions with the public health care system in Bouaké, Côte d'Ivoire, influence their self-reported ability to adhere to antiretroviral prophylaxis during pregnancy. METHODS: Semistructured interviews were conducted with 24 HIV-positive women not eligible for antiretroviral therapy and five health care workers recruited from four public clinics in which prevention of mother-to-child transmission services had been integrated into routine antenatal care. RESULTS: Self-reported adherence to prophylaxis is high, but women struggle to observe (outdated) guidelines for rapid infant weaning. Women's positive interactions with health providers, their motivation to protect their infants and the availability of free antiretrovirals seem to override most potential barriers to prophylaxis adherence. CONCLUSIONS: This study reveals the importance of considering the full continuum of prevention of mother-to-child transmission interventions, including infant feeding, instead of focussing primarily on prophylaxis for the mother and newborn.

Exploring loss to follow-up among women living with HIV in Prevention of Mother to Child Transmission programmes in Côte d'Ivoire.

The expansion of Prevention of Mother to Child Transmission (PMTCT) services globally has been accompanied by significant rates of loss to follow-up (LTFU). This study explored barriers and facilitators to participation in PMTCT programmes for pregnant and post-partum women living with HIV who had been LTFU at public sector antenatal care facilities in the Vallée du Bandama region of Côte d'Ivoire, West Africa. Three types of interviews were conducted at seven health sites: (1) individual or small group interviews with health staff; (2) one focus group with women actively enrolled in PMTCT services; and (3) individual interviews with women who had been LTFU from PMTCT services. Ten main themes emerged and were classified within a modified social ecological model. The individual level barriers included discouragement and internalised stigma, while hope for self/child's health was a facilitator. The family/community level barriers were fear of stigma and gender inequities. The health system level barriers were unclear information and poor post-test counselling, while staff advice and support groups were facilitators. The structural level barrier was associated costs. Factors on all four levels of the social ecological model must be addressed in order to maximise adherence to PMTCT services.