@article{fdi:010074821,
  title = {{H}eterogeneity of virological suppression in the national antiretroviral programme of {C}ameroon ({ANRS} 12288 {EVOLCAM})},
  author = {{L}i{\'e}geois, {F}lorian and {E}ymard-{D}uvernay, {S}abrina and {B}oyer, {S}. and {M}aradan, {G}. and {K}ouanfack, {C}. and {D}omyeum, {J}. and {B}oyer, {V}. and {M}poudi-{N}gole, {E}. and {S}pire, {B}. and {D}elaporte, {E}. and {V}idal, {L}aurent and {K}uaban, {C}. and {L}aurent, {C}hristian and {E}volcam {S}tudy {G}roup,},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjectives {I}n terms of {HIV} infection, western and central {A}frica is the second most affected region world-wide, and the gap between the regional figures for the testing and treatment cascade and the {J}oint {U}nited {N}ations {P}rogramme on {HIV}/{AIDS} ({UNAIDS}) 90-90-90 targets is particularly worrying. {W}e assessed the prevalence of virological suppression in patients routinely treated in 19 hospitals in {C}ameroon. {M}ethods {A} cross-sectional survey was performed in adult patients receiving antiretroviral therapy ({ART}) in the {C}entre and {L}ittoral regions. {T}he prevalences of virological suppression (m{L}) were compared among all 19 hospitals using the chi(2) test. {P}otential individual and health care-related determinants of virological suppression were assessed using multivariate logistic regression models. {R}esults {A} total of 1700 patients (74% women; median age 41 years; median time on {ART} 3.7 years) were included in the study. {T}he prevalence of virological suppression was 82.4% overall (95% confidence interval 80.5-84.2%). {I}t ranged from 57.1 to 97.4% according to the individual hospital ({P} < 0.001). {A}fter adjustment, virological suppression was associated with age, {CD}4 cell count at {ART} initiation, disclosure of {HIV} status to family members, interruption of {ART} for more than two consecutive days, and location of patient's residence and hospital (rural/urban). {T}hese factors did not explain the heterogeneity of virological suppression between the study hospitals ({P} < 0.001). {C}onclusions {T}he overall prevalence of virological suppression was reassuring. {N}evertheless, the heterogeneity of virological suppression among hospitals highlights that, in addition to programme-level data, health facility-level data are crucial in order to tailor the national {AIDS} programme's interventions with a view to achieving the third {UNAIDS} 90 target.},
  keywords = {{A}frica ; antiretroviral ; effectiveness ; {HIV} ; virological outcome ; {CAMEROUN}},
  booktitle = {},
  journal = {{HIV} {M}edicine},
  volume = {20},
  numero = {1},
  pages = {38--46},
  ISSN = {1464-2662},
  year = {2019},
  DOI = {10.1111/hiv.12681},
  URL = {https://www.documentation.ird.fr/hor/fdi:010074821},
}