DOI: 10.5061/dryad.1ns1rn8z6
title: ART uptake and early retention among pregnant women screened HIV infected in informal health centers in Cameroon

description: Informal health centers are booming in Cameroon and are utilized by a
 large part of the population. Most of these IHCs have antenatal care
 services (ANC) and screen pregnant women for HIV.  This dataset
 was collected in informal health centers in two cities in Cameroon: Douala
 and Yaounde. This dataset aimed at firstly, investigate the initiation of
 Antiretroviral therapy (ART) in pregnant women screened positive for HIV
 in antenatal care services of IHCs, three months after HIV screening as
 well as their retention at 3 months post-initiation. Secondly, study the
 association between this intiation and retention with type of PMTCT site
 or model of care ( IHCs that offered integrated ANC and ART, VS those that
 required referral to HIV care centers). Third, identifying associated
 factors to ART non-initiation in this population. From January 2018 to
 July 2020, we carried out a cohort study of pregnant women attending their
 first ANC and screened HIV positive at IHCs in
 Cameroon. Consenting participants  were interviewed at
 three points: the day of the delivery of the antenatal HIV test result, 3
 months later and three months after ART initiation, using anonymous
 standardized questionnaires. The data collected were entered into Kobo
 collect and analyzed in SPSS V23.0 software. Descriptive statistics were
 performed. Frequencies and percentage for categorical variables; median
 and interquartile ranges for continuous variables. Proportions were used
 to calculate ART coverage and retention. Chi-square was used to compare
 the proportions of initiation of ART and retention between group of women
 screened in IHCs without ART and those screened in IHCs with ART
 integrated in antenatal care service. Logistic regression was used to
 identify factors associated to ART non-initiation at 95% confidence
 interval. Baseline variables were initially analyzed univariately and
 those which were significant at the level of 5% were retained for
 multivariable logistic regression. Baseline variables used for this
 purpose were type of PMTCT site, age group, study level, income generating
 activity, income generating activity of partner, relationship duration,
 Primiparity, Pregnancy willingness, perceived self-efficacy of being able
 to initiate ART. A total of 182 pregnant women living with HIV were
 enrolled in the study. At the first ANC, 91% (166/182) were naïve of ART.
 Among them, only 45% (74/166) initiated ART and 65% (48/74) of them were
 retained in ART 3 months later. PWLHIV screened in IHCs with no ART (aOR =
 14.07, 95%CI: 4.68-42.32, p&lt;0.001) and those who doubted their
 perceived capacity to initiate ART (aOR= 15.43, 95% CI: 4.45 to 53.44,
 p&lt; 0.001) were more likely to not initiate ART Given the low
 enrollment in ART among pregnant women living with HIV, screened in
 informal health centers, and the early low retention among those who
 initiated ART, greater attention in PMTCT policies in Cameroon should be
 given to pregnant women screened positive for HIV during ANC in informal
 health centers, in order to guarantee them a continuum of PMTCT care.
description: We conducted a retrospective and a prospective cohort study in
 two towns in Cameroon. Retrospective data were collected from the period
 of January 2018 to April 2019, and the prospective cohort was conducted
 from July 2019 to July 2020. The population consisted of pregnant women
 attending their first ANC and screened HIV positive at IHCs. A total of
 182 Consenting participants were interviewed at three points: at the
 delivery of the antenatal HIV test result, 3 months later, and three
 months after ART initiation, using anonymous standardized questionnaires.
 All  collected data were entered in Kobo Collect and analyzed using SPSS
 Version 23.0 Software As variables, we have Type of IHC
 with two modalities (“ANC integrating ART”, “Refer for ART”);  Age group
 with three modalities (“15-24”, “25-34”, “35-49”); Study level with three
 modalities (“Primary”, “Secondary” and “University”); Income generating
 activity and income generating activity of partner with two modalities
 both (“yes” and “No”); the variable  “Activity sector” have four
 modalities ( “public sector”, “formal private sector”, “informal private
 sector” and  “N/A”. N/A stands for those who did not have any income
 generating activity); Relationship duration with four modalities (“˂ 12
 months”, “1-2 years”, “2-4 years” and “≥4 years”. When performing logistic
 regression, we regrouped them into two modalities “less than 2 years” that
 comprised initial modalities “˂ 12 months” and “1-2 years”, and “≥ 2
 years” that comprised the two other modalities “2-4 years” and “≥4
 years”); Parity with two modalities (“primiparous” and “multiparous”);
 Planning pregnancy with two modalities (“yes” and “no”); Pregnancy
 willingness with two modalities (“yes” and “no”); Weeks of amenorrhea with
 three modalities (“˂ 16”, “16-28” and “˃ 28”); Perceived capacity to
 initiate ART (here we have three modalities: “yes”, “no” and “don’t know”.
 For analysed, we regrouped them in two modalities. The modality “yes”
 stayed “yes,” but modalities “no” and “don’t know” were put together as
 “no/don’t know”); ART Initiation within 3 months with three modalities (
 “no” for those who did not initiate, “yes” for those who initiated and
 “Already on treatment” for those who were in ART at their inclusion in the
 study) ; Time between result and ART initiation (the “N/A” in this
 variable stands for those who did not initiated ART and those who were
 already on ART at the enrolment in the study ); Retention 3 months post
 ART initiation with three modalities (“yes”, “no” and “N/A”. “N/A” stands
 for women who were already on treatment at enrolment in the study). Except
 for the variable “Time between result and ART initiation” which is a
 Discrete numeric variable, all other variables of this dataset are nominal
 categorical variables. Descriptive statistics were
 performed. Frequencies and percentage for categorical variables; median
 and interquartile ranges for continuous variables. Proportions were used
 to calculate ART coverage and retention. Chi-square was used to compare
 the proportions of initiation of ART and retention between group of women
 screened in IHCs without ART and those screened in IHCs with ART
 integrated in antenatal care service. Logistic regression was used to
 identify factors associated to ART non-initiation at 95% confidence
 interval. Baseline variables were initially analyzed univariately and
 those which were significant at the level of 5% were retained for
 multivariable logistic regression.
description: SPSS STATISTICS
 V23.0