According to guidelines, HIV is primarily transmitted through sex. However, results from animal research contradict this theory. The world combats HIV using the same strategies based on the theory of sexual transmission. Contradictorily, a rapid decline in new HIV infections has consistently occurred in global regions where extensive efforts have been made to combat mosquitoes, but not in regions where no such efforts were made. Sexual behaviors do not differ worldwide. Puzzlingly, two-thirds of global HIV infections occur in sub-Saharan Africa, the region with the highest rate of mosquito-borne diseases, and outside sub-Saharan Africa, regions with high mosquito abundance consistently have HIV prevalence rates several to more than 10 times higher than neighboring regions. Sexual activity typically begins upon entering adulthood worldwide. However, in the early stages of the epidemic, unlike Western developed countries where the rates of HIV infection were low in the 15-19 age group, increased gradually thereafter, and peaked in the 25-44 age group, infection rates were already high in the 15-19 age group in Africa, Asia, and other regions. Contradictions are common in HIV research. They are resolved if HIV is primarily transmitted by mosquitoes. Anyone can easily test these issues by examining global data. Research communities must resolve these issues.
Cervical cancer is the most common cancer in women in Zimbabwe with approximately 3,000 women being diagnosed and close to 2,000 succumbing to the malignancy annually. HIV remains one of the drivers of cervical cancer in Zimbabwe. In 2019, an estimated 20% of eligible women in Zimbabwe accessed cervical cancer screening services. In collaboration with the Ministry of Health and Child Care, JF Kapnek Zimbabwe, a local NGO, is implementing the Target, Accelerate, Sustain Quality Care for HIV epidemic control, (TASQC program) in six districts in Masvingo province. Visual Inspection with Acetic Acid (VIAC) is offered to women living with HIV targeting the 25 to 49 years age group. Services are provided daily at 20 health care facilities while 150 facilities and health posts are visited quarterly for outreach services. Between April 2022 and August 2024, a total of 86,499 VIAC screenings were done, reaching 119% of the target, which were approximately 2500 per month. Over 40% of all screenings were done at community level with districts like Zaka (62%) and Chivi (57%) doing most of their screening at community level. A total of 115,105 WLHIV were mobilized for VIAC by community volunteers. VIAC positivity at facility level was 6% while at community level was 5%. Treatment coverage of 85% was achieved with most women treated via LEEP followed by thermocoagulation. Treatment was mostly at facility level. The main challenges noted in this program were staff attrition, competing community programs and difficulties accessing some geographical areas, especially in the rainy season. Community based cervical cancer screening can be a way to scale up access to women from hard-to-reach areas. Resources need to be availed to ensure more access to vulnerable women.
Background: An increasing number of first line Anti-retroviral therapy (ART) patients in resource limited countries are experiencing regimen failure and are switched to second line ART. However, predictors of second line ART virologic failure in Cameroon are scarce. This study aimed at investigating the predictors of virologic failure of second line ART regimen amongst adult patients in the Northwest Region of Cameroon. Method: A cross-sectional study was conducted among adults on second line ART between January 2018 and December 2021 at 3 purposefully selected health facilities. Study participants were systematically selected to include participants on second line ART with documented first line and second line viral load information. Data was extracted from clients’ files and analyzed using SPSS version 25. Results: A total of 157 second line ART clients were sampled with majority (69%) being males. The median time to switch to second line ART from the time of first high viral load on first line ART was 18 months (SD=8). The second line ART virologic failure rate was estimated at 16%. Significant predictors of second line ART virologic failure were baseline CD4 >200 copies/ml (AOR: 5.06, 95% CI: 1.54-16.61, p = 0.007) and fair adherence AOR: 19.21, 95% CI: 5-75.37, p = 0.001). Conclusion: Baseline CD4 counts greater than 200 cells/mL and fair adherence were significant predictors of virologic failure of second-line ART. The Midian duration from first high viral load to switch was high at 18 months. Strategies to improve adherence with more attention on the 18-30 years age group will help reduce virologic failure rate of second line ART. Patients on first line ART with high viral load should be closely monitored and provided with treatment support to ensure that those with a persistent high viral load are identified and switched to second line earlier than 12 months to improve their treatment outcomes.
Background: We evaluated for the first time in Cameroon, the performance of a rapid test that detects the presence of specific antibodies to Human Immunodeficiency Virus (HIV) in urine sample, compared to two bloods based rapid tests used for HIV screening in Cameroon. The aim of the study was twofold; [1] to evaluate the diagnostic accuracy (sensitivity and specificity) of the WANTAI HIV URINE rapid test kit (Beijing Wantai), compared to the two blood based rapid antibody tests, Determine HIV 1/2 and Ora Quick HIV-1/2, currently in use in the Cameroon national HIV testing algorithm, and [2] An HIV ‘self-test’ (HIVST) usability study using the WANTAI HIV Self-test by Urine. Method: This was a comparative study where urine and blood specimens were collected simultaneously from each patient, tested for HIV and results of the two tests compared immediately. All interested sexually active adult patients 21yrs and above sent to the hospital laboratory for HIV test and others tests were enrolled in the study after signing an informed consent form. 330 patients opted for the HIV self-testing. All HIV positive and discordant samples were confirmed on western blood and the statistical analysis calculated using Wilson’s method. HIV sub typing was done on all confirmed HIV positive plasma samples. Results: From November 2020 to February 2021, 1000 patients had their urine and blood Specimens tested for HIV. The test performances of both tests were as follows; Determine had a sensitivity of 100%, specificity of 98.72% and a kappa value of 0.860. Meanwhile WANTAI had a sensitivity of 100%, specificity of 99.37% and a kappa value of 0.925. Conclusion: Both Determine and WANTAI have excellent sensitivity (>99%) and specificity (>98%) as per the WHO standards. However, WANTAI showed an overall better performance as compared to Determine, supported by an almost perfect agreement with Western Blot. In a nutshell, WANTAI therefore appears as an outstanding assay for HIV screening. Furthermore, it’s non-invasive/painless approach, its optimal privacy (i.e. reduced stigma/discrimination), and rapidity, accurate and user-friendliness makes it a significantly superior test for scaling-up HIV testing and linkage to care in resource-limited settings.
Background: Barriers to Human Immunodeficiency Virus (HIV) and Hepatitis C (HCV) testing and care persist, especially among high-risk populations in medically underserved areas, where limited testing accessibility, stigma, and systemic inequities hinder early diagnosis and treatment. In Southern New Jersey, substance use and mental health treatment facilities serve populations with increased vulnerability to HIV and HCV, yet testing and retention of care remain suboptimal. To address these challenges, we developed a “Group Risk Reduction and Testing” (GRREAT) Model, an interdisciplinary, group-based approach integrating harm reduction counseling, peer support, and rapid testing to enhance screening rates, reduce stigma, and improve patient engagement with care. Unlike traditional individual testing models, the GRREAT Model leverages group therapy principles to create a supportive environment that facilitates knowledge sharing, increases testing uptake, and fosters open conversations surrounding risk behaviors. Methods: From June 2023 to September 2024, weekly group testing sessions were conducted at residential treatment facilities in medically underserved areas of Southern New Jersey, evaluated using a mixed-methods approach. Participants received educational presentations, rapid HIV and optional HCV antibody testing, and individualized results counseling. Quantitative data included surveys measuring satisfaction, comfort, and perceptions of privacy and confidentiality, which were then interpreted using ender-stratified analyses involving descriptive statistics and chi-square tests. Qualitative feedback was analyzed thematically. Results: A total of 452 participants completed surveys (348 men, 104 women). Participants were predominantly male (77%) and gender differences were the primary focus of the analysis, as data on other demographic factors such as age and ethnicity were not collected. Participants reported high satisfaction, with 95% of women and 74% of men rating their care as “Excellent.” A statistically significant gender difference was observed in overall care ratings (p=0.007, Cohen’s d=0.303), with women reporting higher levels of overall satisfaction. A smaller but statistically significant difference was noted in preferences for privacy in counseling (p=0.034, Cohen’s h=-0.100), though men and women reported similar levels of comfort and confidence in confidentiality. Thematic analysis of participant comments identified key themes, including “Trust and Emotional Safety,” “Interpersonal dynamics,” “Program Impact and Effectiveness,” and “Value Recognition” of the program. Conclusions: The GRREAT Model demonstrated strong acceptability among participants and effectiveness in improving perceptions of HIV/HCV testing and harm reduction counseling respective of patient gender. This peer-supported, group-based intervention not only allows for increased testing rates but also fosters open discussions around HIV, harm reduction strategies, and sobriety treatment adherence. Given the high satisfaction ratings and minimal gender differences, this scalable approach holds promise for broader implementation in diverse medical settings. Future research should explore long-term impact, refine strategies for balancing privacy in group settings, and assess how this model can be adapted to different populations to maximize its effectiveness in reducing health disparities.
