Authors: Manomba Boulingui C, Moutombi Ditombi B, Mongo Delis A, Lengongo J, Mihindou J, Essomeyo Ngue M, Ntsame Owono Michele M, Edou P, Mbondoukwe N, Ndong Ngomo J, Mawili Mboumba DP, Bouyou Akotet M.
Introduction: Antiretroviral treatment (ART) and the prevention of opportunistic diseases are key factors in assessing the effectiveness of HIV control programs. This study assessed the level of ART and cotrimoxazole coverage, and associated factors in HIV-infected persons (PLHIV) in Gabon.
Methods: This was a retrospective study which included data from PLHIV aged over 15 years and attending their routine follow-up visits from February to June 2018 at three HIV care and treatment outpatient centers. The use of antiretroviral treatment (ART) and cotrimoxazole (CTX) prophylaxis, age, gender, the time from diagnosis to the last visit were recorded.
Results: Data of 927 PLHIV were analyzed. More than two-thirds were women. The median age was 43 [35-52] years, the median CD4+T cell count was 352 [177-533]/mm3 . ART and CTX chemoprophylaxis coverage were 83.9% and 39.2% respectively. Among the 778 PLHIV on ART, 68.8% had recent CD4+T cell measurements, whereas this proportion was higher (78.5%) in the absence of ART (p=0.01), and 19.2% (n=60/324) were eligible for ART. A higher proportion of PLHIV in the rural city received second-line treatment (p<0.01). Rural participants more frequently received CTX prophylaxis (49.7% vs. 37.1% in the urban city; p<0.01). Overall, 53.1% of patients with recent HIV diagnosis, 26.9% of those with an opportunistic infection and 16% of the immunosuppressed ones were not on ART nor under CTX chemoprophylaxis.
Conclusion: ART coverage is still under 90% and CTX chemoprophylaxis coverage is still low in Libreville. HIV testing and early ART initiation of should be promoted at outpatient center.
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