|Author(s):||D. M. Njamnshi*1, J. Y. Fonsah2, F. N. Yepnjio2, C. Kouanfack1, A. K. Njamnshi2|
|Affiliation(s):||1HIV Day Care Centre, 2Neurology, Central Hospital Yaounde, Cameroon|
|Keywords:||HIV/AIDS, socio-economic status, ARV, Cameroon.|
HIV/AIDS is a pandemic worldwide especially in sub-Saharan Africa. Cameroon had 590,000 persons with HIV/AIDS with some 46,000 deaths / year in 2005*. Social and economic factors have been associated with HIV transmission and morbidity. Poverty and economic inequality have clearly been associated with HIV transmission*. Few studies have examined this association in Cameroon. We hypothesized that the social and economic status of patients affects their present HIV serological status may affect access to Anti-Retroviral (ARV) drugs, compliance and adherence in Yaounde, Cameroon. At time of study, ARV regimens cost between 3000 and 7000 Francs CFA.
To examine possible associations between socio-economic factors and HIV seropositivity and access to ARV treatment in our context. The design was a cross-sectional descriptive study in a tertiary health facility. Patients who signed a consent form were interviewed at the Day-Care Hospital, Yaoundé Central Hospital between October and December 2006. Administrative authorization and ethical clearance for research were obtained from the Ministry of Public Health and the National Ethics Committee respectively.
The female to male ratio was 2.4:1 %, n=94. The mean age of the sample was 37.3 ± 8.9 years. The mean age of the males was 41.52 ± 8.99 years; that of females was 35.5 ± 8.38 years, p=0.003. Concerning marital status, 50 (54.3 %) of the patients were currently married while 21.7 % were single. Fifteen (16.3 %) were widowed and 7 (7.6%) were divorced. Of those once married, 76.2 % were involved in monogamous relationships and 23.8 % were in polygamous relationships. For the patients with stable relationships, their partners were mainly housewives (25.4 %), farmers (10.2 %), or uniformed men/women (10.2 %). A high percentage of the whole sample consisted of housewives (22.8 %), followed by individuals in business (17.4%) and then the unemployed (14.1 %). Half of the patients (50.0 %) had up to secondary school level education, while 38.0 % had primary education and 9.8 % had attended university; 2.2 % never had any formal education. Considering risk behaviour assessment, all the respondents were sexually active, 65.8 % having multiple sexual partners. Only 12.0% reported regular use of condom against 25.0 % that never used one (p=0.007). Marital status did not seem to affect condom use significantly. Almost half (42.4 %) of the patients were occasional consumers of alcohol. Alcohol consumption was significantly associated with the availability of a stable source of income; p = 0.007. We did not find any IV drug users or homosexuals in the sample. More than half (55.4 %) of the respondents had a stable source of income. Up to 25.5 % of these lived on < 10,000 FCFA per month; 23.5 % declared an income of > 100,000 FCFA/month, and 5.9 % an income between 50,000 and 100,000 FCFA. ARV treatment was afforded by 52.2 % of patients themselves while 47.8 % received theirs through the help of family members (30.4 %), husband (9.8 %), NGOs (7.6 %).
HIV transmission in our sample is essentially through heterosexual behaviour, favoured by multiple sexual partners and very little protection (condom use), thus the need for more sensitisation. Less than half of our sample could not afford ARV treatment by themselves and this could affect compliance and adherence to therapy, so the need for universal access to ARVs.