WHO | Yaoundé – Nicole, 28, from Bertoua in eastern Cameroon, will never forget that day in 2019 when her doctor at Batouri Catholic Hospital told her she was HIV-positive. She had gone for a medical check-up a few days previously after feeling ill, but HIV was the furthest thing from her mind. She froze, she recalls, wondering how it was possible. But as the shock began to wear off, the doctor informed her of her options, including treatment.
Cameroon was estimated to be home to 480 232 people living with HIV in 2022, with 9905 new cases recorded that year. Although still a major public health problem, recent encouraging progress includes a 50% decrease in HIV prevalence among people aged 15 to 64 in the past 14 years, according to the most recent Demographic Health Survey 2018 (DHS). Prevalence fell from 5.4% in 2004, to 4.3% in 2011, and 2.7% in 2018.
Dr Hamsatou Hadja, permanent secretary of Cameroon’s National AIDS Control Committee, says the decline is thanks to a focused strategy. “The fight against HIV is organized around a national vision, which is to put an end to AIDS as a threat to public health by 2030, by reducing new infections, deaths and stigma associated with HIV,” she explains.
The country is on track to achieve the global “95-95-95” target: 95% of people with HIV know their status, 95% of those who know their status are on treatment, and 95% of those on antiretrovirals have a suppressed viral load. According to the Committee, the rates as of 2022 were 95.8%, 92.3% and 89.2% respectively.
World Health Organization (WHO) has supported Cameroon in the efforts to lower the HIV burden, including through training health workers. For instance, in 2022, WHO deployed HIV experts to 36 health facilities in 14 health districts in the country’s East and Littoral regions. Around 200 health workers received training on various aspects of HIV care. In addition, more than 20 000 people were screened for HIV and, of the 590 who tested positive, 545 were put on treatment.
Service providers are now better equipped and more confident in providing treatment. Sergine Nyaviene, care assistant and psycho-social specialist at the Tigaza Catholic Health Centre, is one of the health professionals who benefited from WHO’s training. She has been working with people living with HIV for seven years. “I had lost a lot of people in my home and among my friends to AIDS. That led me to choose a career in health,” she says.
The training also positively impacts the attitudes of staff and so the quality of HIV care, she adds, with the number of people living with HIV being assisted by the centre increasing from 65 in 2020, to 158 by October 2023. “I’ve learnt a lot and I’m able to advise my patients. For example, many people didn’t know that you could live in the same house as someone living with HIV, eat together and sleep in the same bed, without being infected. Or that it is possible for an HIV-positive mother to safely continue breastfeeding her child.”
As part of its ongoing support to Cameroon, WHO is working with thehealth authorities to develop and expand a people-centred approach to differentiating HIV services. “One of our organization’s policies is to combat the inequalities that are hampering the elimination of HIV, which is why key populations and internally displaced people (IDPs) are a priority focus for us. These vulnerable populations often do not have access to adequate HIV services,” explains Dr Gilbert Tchatchoua, WHO Country Office expert in accelerating access to HIV services.
In 2022, 1183 men who have sex with men (MSM) and 1944 female sex workers (FSW) were screened for HIV, and 190 MSM and 245 FSW began treatment. An additional 326 IDPs were screened, 30 of whom tested positive and were put on treatment.
However, a major challenge that remains is the stigma and discrimination surrounding the disease, says Dr Tchatchoua, pointing out that “we need to raise awareness in communities so they understand that HIV is an illness like any other, but one that requires medical attention.”
“Communities must be at the centre of everything, and we will only be able to achieve the goal of putting an end to AIDS as a threat to public health by 2030 if grassroots communities are heavily involved,” he adds.
Nicole has fortunately been the recipient of good advice and solid support. “My mother knows about my status and is always encouraging me. The health staff also give me advice during appointments, which I always follow.”
In Bertoua, Nicole is now the mother of three healthy children born HIV-free, and continues to follow her treatment to the letter. “I no longer feel unwell. I lead a normal life as a hairdresser, and I choose to live positively. I also advise my friends to get tested and, if they are positive, to start treatment to save their lives.”