| Issue/Objective |
Cameroon's Population-based HIV Impact Assessment 2017-2018 found that 56% of people living with HIV knew their status. We examined five-year trends in HIV testing and case identification between 2019 and 2024 in two Cameroonian regions accounting for approximately 22% of all people living with HIV nationwide, and secondarily aimed to contextualize observed changes alongside major programmatic and external events. |
| Methodology/Approach |
We conducted an ecological assessment using HIV program data from the Littoral and South regions of Cameroon between October 2019 and
September 2024. Trends in testing and case identification were analyzed
using a joinpoint regression model. To contextualize quantitative trends,
we examined qualitative information from quarterly and annual project
reports regarding specific events including test kit stockouts, COVID-19
outbreaks, and project reorganization. |
| Results |
Overall, 1,209,617 individuals were tested and 56,975 (4.7%) people living with HIV were identified during 2019-2024. Testing significantly decreased between October 2019 and May 2020 (monthly percentage change -6.3%; 95% CI -9.2% to -3.3%), coinciding with national test kit stockouts from November 2019 to February 2020, followed by the first COVID-19 wave from March to May 2020. The June-September 2020 period showed a non-significant increasing testing trend (monthly percentage change 6.6%; 95% CI -8.5% to 24.1%) corresponding to enhanced COVID-19 mitigation activities. A small but
significant decreasing trend followed between October 2020 and September
2023 (monthly percentage change -0.4%; 95% CI -0.7% to 0.0%), corresponding to subsequent COVID-19 waves and test kit stockouts.
The October 2023 to September 2024 period showed a further decreasing
testing trend (monthly percentage change -2.6%; 95% CI -4.7% to -0.4%)
during the reorganization of service delivery modalities. Critically, case
Identification increased from October 2019 to September 2023 despite
declining testing volumes, suggesting improved targeting and testing
yield during periods of constrained testing capacity. |
| Discussion/Conclusion |
Despite declining testing volumes during much of the study period. HIV case identification improved through September 2023, suggesting that constrained testing capacity drove more targeted approaches with higher yield. Concurrent declines in both testing and case identification after September 2023 may indicate broader disruptions associated with service delivery reorganization, warranting urgent programmatic attention.
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| Presenters and Affiliations |
Ntambara Steven Centre for Impact, Innovation and Capacity building for Health Information Systems and Nutrition (CIIC-HIN), Kigali, Rwanda |
