Associated Factors of Early and Late Initiation of ART in HIV Infected Pregnant Women in the South West Region, Cameroon

Background: The prevention of mother to child transmission of HIV regimen called Option B+ requires that all HIV positive pregnant women begin Antiretroviral Therapy (ART) as soon as they are tested. Efforts geared towards achieving an increase in Antiretroviral Therapy uptake among HIV pregnant women still have not produced expected results given that some of these women are reluctant to start treatment following diagnosis. It was then imperative to examine the factors that influence the choice of when these women accept to begin ART, be it early or late.

Methods: We conducted a cross-sectional analytic study in six health facilities in the South West region of Cameroon. Two groups of HIV positive pregnant women were recruited in these facilities; those who accepted early Antiretroviral Therapy initiation within a week of diagnosis and those who accepted Antiretroviral Therapy initiation later than one week from diagnosis. Data were entered into and analysed by Epi info version 7.2.2.6. The Chi-square test was used to test for statistical significance with Alpha set at 0.05. Multivariate analysis was performed to eliminate confounders.

Results: One hundred and eighty HIV positive pregnant women were recruited with a mean age of 28.9years (SD=2.4years). HIV infected pregnant women diagnosed during an antenatal care (ANC) visit were more likely to be initiated on antiretroviral therapy early ((Odd ratio) =21.7, 95% CI 3.2-143.7, p=0.00067). State-run facilities were less likely to initiate clients early (Adjusted odd ratio=0.2, 95% 0.05-0.6, p=0.00018). Antenatal care visit and facility type were significantly associated with early initiation of antiretroviral therapy.

Conclusion: Additional efforts are required to course pregnant women to go for early antenatal care visit while state-run health facilities need assistance to improve on early Antiretroviral therapy initiation for clients in need. These efforts could contribute to reducing paediatric HIV in the Cameroonian population.