RESEARCH ARTICLE
Adherence to Antiretroviral Therapy (ART) in ´-Cameroon: Association with Yaounde Opportunistic Infections, Depression, ART Regimen and Side Effects Julius Y. Fonsah1,2, Alfred K. Njamnshi1,2, Charles Kouanfack2,3, Fang Qiu4, Dora M. Njamnshi3, Claude T. Tagny2,5, Emilienne Nchindap5, Le´opoldine Kenmogne5, Dora Mbanya2,5, Robert Heaton6, Georgette D. Kanmogne7*
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1 Department of Neurology, Yaounde´ Central Hospital, Yaounde´, Cameroon, 2 Faculty of Medicine and Biomedical Sciences, University of Yaounde´ I, Yaounde´, Cameroon, 3 HIV-Day Care Service, Yaounde´ Central Hospital, Yaounde´, Cameroon, 4 Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States of America, 5 Yaounde´ University Teaching Hospital, Yaounde´, Cameroon, 6 Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, United States of America, 7 Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America *
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Abstract OPEN ACCESS Citation: Fonsah JY, Njamnshi AK, Kouanfack C, Qiu F, Njamnshi DM, Tagny CT, et al. (2017) Adherence to Antiretroviral Therapy (ART) in Yaounde´-Cameroon: Association with Opportunistic Infections, Depression, ART Regimen and Side Effects. PLoS ONE 12(1): e0170893. doi:10.1371/journal.pone.0170893 Editor: Anil Kumar, University of Missouri Kansas City, UNITED STATES Received: October 22, 2016 Accepted: January 12, 2017 Published: January 31, 2017 Copyright: © 2017 Fonsah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper. Funding: This work was supported by NIMH R01 MH094160. Competing Interests: The authors have declared that no competing interests exist.
Following global efforts to increase antiretroviral therapy (ART) access in Sub-Saharan Africa, ART coverage among HIV-infected Cameroonians increased from 0% in 2003 to 22% in 2014. However, the success of current HIV treatment programs depends not only on access to ART, but also on retention in care and good treatment adherence. This is necessary to achieve viral suppression, prevent virologic failure, and reduce viral transmission and HIV/AIDS-related deaths. Previous studies in Cameroon showed poor adherence, treatment interruption, and loss to follow-up among HIV+ subjects on ART, but the factors that influence ART adherence are not well known. In the current cross-sectional study, patient/self-reported questionnaires and pharmacy medication refill data were used to quantify ART adherence and determine the factors associated with increased risk of non-adherence among HIV-infected Cameroonians. We demonstrated that drug side-effects, low CD4 cell counts and higher viral loads are associated with increased risk of non-adherence, and compared to females, males were more likely to forego ART because of side effects (p
