TY - JOUR
T1 - Gender, Mental Health, and Entry Into Care with Advanced HIV Among People Living with HIV in Cameroon Under a National ‘Treat All’ Policy
AU - Parcesepe, Angela M.
AU - Filiatreau, Lindsey M.
AU - Ebasone, Peter Vanes
AU - Dzudie, Anastase
AU - Ajeh, Rogers
AU - Wainberg, Milton
AU - Pence, Brian
AU - Pefura-Yone, Eric
AU - Yotebieng, Marcel
AU - Nsame, Denis
AU - Anastos, Kathryn
AU - Nash, Denis
N1 - Funding Information:
Data were collected from in-person interviews with 426 individuals newly initiating HIV care at three HIV treatment clinics in Cameroon between June 2019 and March 2020. Study sites were selected because they were participating in the Central Africa International epidemiology Databases to Evaluate AIDS (CA-IeDEA) Cameroon study. IeDEA is a research consortium established with funding from the National Institute of Allergy and Infectious Diseases to collect and harmonize global HIV data []. All study sites provide outpatient HIV care and treatment services. Individuals were eligible to participate if they were 21 years or older and newly enrolling in HIV care at one of the three HIV clinics. Individuals transferring care were ineligible. Data collection consisted of one structured interview conducted by a trained research assistant and included questions on mental health, substance use, psychosocial stressors, and sociodemographics. Research assistants were fluent in English and French. Interviews were conducted in English or French, based on the preference of the participant. Study participants also had their CD4 cell counts measured at the HIV care facility within two weeks of enrollment into HIV care. This study was approved by the Institutional Review Board at the University of North Carolina at Chapel Hill and from the National Ethical Committee of Research for Human Health in Yaoundé, Cameroon. All participants provided written informed consent.
Funding Information:
This research was supported by NIMH Grant K01 MH114721 , NICHD Grant P2C HD050924 (Carolina Population Center), NIAID Grant P30 AI050410 (UNC Center for AIDS Research), and NIAID Grant U01AI096299. This work is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned above.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2021/12
Y1 - 2021/12
N2 - Delays in diagnosis and linkage to HIV care persist among people living with HIV (PLWH), even after expanded access to ART worldwide. Mental health may influence timely linkage to HIV care. Greater understanding of the relationship among gender, mental health, and delayed linkage to HIV care can inform strategies to improve the health of PLWH. We interviewed 426 PLWH initiating HIV care in Cameroon between June 2019 and March 2020 to estimate the prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) and the association between mental health and entry into care with advanced HIV. Separate multivariable log binomial regression models were used to estimate the association between mental health exposure and entry into HIV care with advanced HIV. Stratified analyses were used to assess effect modification by gender. Approximately 20, 15, and 12% of participants reported symptoms of depression, PTSD, and anxiety, respectively. The prevalence of mental health symptoms did not vary significantly by gender. Overall, 53% of participants enrolled in HIV care with advanced HIV: 51% of men and 54% of women. Screening positive for one of the mental health disorders assessed was associated with greater prevalence of enrollment with advanced HIV among men, but not among women. Future research should examine gender-specific pathways between mental health symptoms and entry into care with advanced HIV, particularly for men in Cameroon. The extent to which untreated mental health symptoms drive gender disparities throughout the HIV care continuum should be explored further.
AB - Delays in diagnosis and linkage to HIV care persist among people living with HIV (PLWH), even after expanded access to ART worldwide. Mental health may influence timely linkage to HIV care. Greater understanding of the relationship among gender, mental health, and delayed linkage to HIV care can inform strategies to improve the health of PLWH. We interviewed 426 PLWH initiating HIV care in Cameroon between June 2019 and March 2020 to estimate the prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) and the association between mental health and entry into care with advanced HIV. Separate multivariable log binomial regression models were used to estimate the association between mental health exposure and entry into HIV care with advanced HIV. Stratified analyses were used to assess effect modification by gender. Approximately 20, 15, and 12% of participants reported symptoms of depression, PTSD, and anxiety, respectively. The prevalence of mental health symptoms did not vary significantly by gender. Overall, 53% of participants enrolled in HIV care with advanced HIV: 51% of men and 54% of women. Screening positive for one of the mental health disorders assessed was associated with greater prevalence of enrollment with advanced HIV among men, but not among women. Future research should examine gender-specific pathways between mental health symptoms and entry into care with advanced HIV, particularly for men in Cameroon. The extent to which untreated mental health symptoms drive gender disparities throughout the HIV care continuum should be explored further.
KW - Cameroon
KW - Gender
KW - HIV
KW - Mental health
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U2 - 10.1007/s10461-021-03328-3
DO - 10.1007/s10461-021-03328-3
M3 - Article
C2 - 34091803
AN - SCOPUS:85107479888
SN - 1090-7165
VL - 25
SP - 4018
EP - 4028
JO - AIDS and Behavior
JF - AIDS and Behavior
IS - 12
ER -
