Abstract

The HIV/AIDS Pandemic is a major public health problem globally with an estimated 37.7 million people living with it and 680,000 deaths from HIV related illnesses worldwide in 2020. In 2020, HIV prevalence in Cameroon was 3 %. And today 3.7 % of adults are living with HIV in Cameroon.

There is currently no effective cure. Once people get HIV, they have it for life. But with proper medical care, HIV can be controlled. People with HIV who get effective HIV treatment can live long. The burden of People living with HIV/ADS in Cameroon is still relatively high and they is insufficient data on client’s satisfaction in South West Region. This study aims to assess patient’s satisfaction with HIV/AIDS Treatment services rendered by healthcare professionals.

This study was a Facility-based quantitative study.A purposive sampling was used to select treatment centers used for the study. Probability proportionate to sample size was used to calculate the number of questionnaires shared in each treatment centres. Convinience samplying use to sample 255 participants. Data collected was entered into Kobo collect and analyzed using SPSS version 25.  This study found out that, majority (83%) of HIV patients in the three treatment centers sampled were satisfied with the HIV services rendered to them by staff of these centers. Also no association was found between satisfaction with treatment services and demographic characteristics of patients.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

HIV (Human Immunodeficiency Virus) is a virus that attacks the body’s immune system. If HIV is not treated, it can lead to AIDS (Acquired Immunodeficiency Syndrome).There is currently no effective cure. Once people get HIV, they have it for life. But with proper medical care, HIV can be controlled. People with HIV who get effective HIV treatment can live long, healthy lives and protect their partners[1]. HIV infection happens in three stages. Without treatment, it gets worse over time and eventually overpowers your immune system.

Your symptoms will depend on your stage. In stage 1, Also known as the acute or primary phase, most people don’t even know they have been affected with the virus, symptoms may show up within 2-6 weeks after infection and symptoms are similar to those of other viral infections and often compared to flu. Symptoms often last for 1-2 weeks then goes away, this includes headache, fatigue, aching muscles, sore throat, swollen lymph nodes, red rash that doesn’t itch, fever, ulcers (sores) in the mouth, anus, esophagus and genitals[2].

The second stage also known as the clinical latency stage, asymptomatic stage, or chronic HIV infection stage occurs when the immune system loses the battle with HIV, Flu-like symptoms go away. Untreated will kill the body’s CD4 cells and destroy the body’s immune system and without treatment your CD4 cells drops hence more likely to get other infections. During this stage you can pass HIV over to others but if you take your medicine, your chances of transmitting it to others is low. The third stage is also known as the AIDS stage. AIDS is the advanced stage of HIV infection.

This is usually when your CD4 T-cell number drops below 200 and your immune system is badly damaged. You might get an opportunistic infection, an illness that happens more often and is worse in people who have weakened immune systems. Some of these, such as Kaposi’s sarcoma (a form of skin cancer) and pneumocystis pneumonia (a lung disease), are also considered “AIDS-defining illnesses. ”If you didn’t know earlier that you were infected with HIV, you may realize it after you have some of these symptoms: Being tired all the time, Swollen lymph nodes in your neck or groin, Fever that lasts more than 10 days, Night sweats, Weight loss with no obvious reason, Purplish spots on your skin that don’t go away, Shortness of breath, Severe, long-lasting diarrhea, Yeast infections in your mouth, throat, or vagina, Bruises or bleeding you can’t explain, Neurological symptoms such as memory loss, confusion, balance problems, behavior changes, seizures, and vision changes[2]. HIV is a sexually and parenterally transmitted disease, few prevention methods are available. Sexual transmission of HIV could be prevented largely through abstinence, fidelity, and condom use; and transmission via IDU primarily through changing addiction behaviors[4].

The HIV/AIDS Pandemic is a major public health problem globally with an estimated 37.7 million people living with it and 680,000 deaths from HIV related illnesses worldwide in 2020[3]. Despite this huge number of people living with HIV/AIDS, only 28.2 million people have access to antiretroviral therapy (ART) as of June 2021. In 2020, 1.5 million people became newly infected with the virus and 79.3million people have become infected with the virus since the start of the pandemic. An estimated 36.3 million people have died from AIDS-related illnesses since the start of the pandemic[5]. The above global statistics give us a clue on how serious and deathly the disease is hence it should be handled as such.

In Africa, HIV infection in humans came from a type of chimpanzee in Central Africa. The chimpanzee version of the virus (called simian immunodeficiency virus, or SIV) was probably passed to humans when humans hunted these chimpanzees for meat and came in contact with their infected blood. Studies show that HIV may have jumped from chimpanzees to humans as far back as the late 1800s. Over decades, HIV slowly spread across Africa and later into other parts of the world. We know that the virus has existed in the United States since at least the mid to late 1970s[1].

Despite the fact that sub-Saharan Africa contains only about 11 percent of the Earth’s population, the region is the world’s epicenter of HIV/AIDS[6].The WHO African Region is the most affected region, with 25.7 million people living with HIV in 2018. The African Region also accounts for almost two thirds of the global total of new HIV infections. In 2018, about 1.1 million people were infected with HIV in the African Region[7].

East and Southern Africa is the region most affected by HIV in the world and is home to the largest number of people living with HIV. The HIV epidemic in this region is generalized but young women, men who have sex with men, transgender people, sex workers, prisoners and people who inject drugs are at an increased vulnerability to infection. Although laws and cultural traditions vary between East and Southern African countries, there are a number of ingrained cultural, structural and legal barriers to HIV prevention [8].

South Africa accounted for more than a quarter  (240,000) of the region’s new infections in 2018. Seven other countries accounted for more than 50% of new infections: Mozambique (150,000), Tanzania (72,000), Uganda (53,000), Zambia (48,000), Kenya (46,000), Malawi (38,000), and Zimbabwe (38,000). Overall, new infections in the region have declined by 28% since 2010. Around 310,000 people died of AIDS-related illnesses in the region in 2018, although the number of deaths has fallen by 44% since 2010.

Despite the continuing severity of the epidemic, huge strides have been made towards meeting the UNAIDS 90-90-90 targets. In 2018, 85% of people living with HIV were aware of their status, 79% of them were on treatment (equivalent to 67% of all people living with HIV in the region), and 87% of those on treatment [8].

The first AIDS cases were reported in Cameroon in 1985 and ten years later, in 1995, an official total of 2766 had been notified with a cumulative number of 8,141. Similarly the prevalence of the HIV infection in Cameroon has progressively risen from 0.4% in 1987 to 1.2% in 1990 and from 4% in 1992 to about 7% in 1997, to 11% in 2000[9]. In 2020, HIV prevalence for Cameroon was 3 %. HIV prevalence of Cameroon fell gradually from 4.8 % in 2001 to 3 % in 2020 and today, a survey was carried out by CAMPHIA and it was noticed  that 3.7 percent of adults are living with HIV in Cameroon, representing approximately 500,000 individuals.

The annual rate of new HIV infection among adults was 0.24, or 31,000 new cases per year. Based on self-reported and antiretroviral (ARV)-detection data, it is estimated that, at the time of the survey, 55.6 percent of adults in Cameroon were aware of their HIV status; of those diagnosed, 93.1 percent were receiving antiretroviral treatment; and of those on treatment, 80.1 percent had achieved viral load suppression. Though there has been considerable progress in the nation towards achieving the second and third of the UNAIDS 90-90-90 targets, HIV diagnosis remains a challenge.

The survey also found that, HIV prevalence among adults was about two times higher among women (5.0 percent) than in men (2.3 percent). In addition, the survey identified a testing gap among young people aged 15-24 years: Only 20.7 percent of young people living with HIV were aware of their HIV status based upon self-report and ARV-detection data[10].

1.2 Problem Statement

HIV/AIDS Pandemic is a major public health problem hitting the world today[3]. The World Health Organization and UNAIDS estimated that 36.9 million people were living with HIV in 2017 globally. In the same year, 1.8 million people became newly infected with HIV and 940,000 people died of AIDS-related illnesses[11]. In 2020,  37.7 million people in the world were living with HIV, 73% of PLWHA had access to ART while 16% of all PLWHA did not know that they had HIV[7].

A survey was also carried out by CAMPHIA in 2021 and it was noticed that 3.7 percent of adults are living with HIV in Cameroon, representing approximately 500,000 individuals. The annual rate of new HIV infection among adults was 0.24, or 31,000 new cases per year[9].  The above statistics gives us a clue on the burden of the disease worldwide and in Cameroon hence a call for concern.

A lot of HIV positive patients are still dissatisfied with the care they receive from medical personnels regarding their conditions. Again, HIV care decentralization has been enforced as a national policy in Cameroon but there has been few attempts to examine the performance of this policy and particularly its role in protecting against catastrophic health expenditures.

The Catholic Relief Services reports that in Cameroon, follow-up of people living with HIV is provider-oriented, that there is little client education and limited client involvement in clinical monitoring. Furthermore, the health care system frequently experiences low access to quality drugs, inadequate staffing, coordination and management of commodities for HIV, further compounded by the fact that only 6 % of government’s budget is allocated to health.

This kind of services may lead to poor patient satisfaction associated with poorer HAART treatment outcomes and lower treatment adherence[12].  Clients have explicit desires or requests for services when visiting hospitals; inadequate discovery of their needs may result in dissatisfaction. Patient satisfaction influences retention in HIV care, adherence to HAART and serves as determinant to HIV suppression[12].

1.3 Research Questions

1. What percentage of people living with HIV/AIDS (PLWHA) express satisfaction with overall HIV service?
2. Is there any association between client satisfaction with HIV treatment services and socio-demographic variables?
3. Are there some factors influencing dissatisfaction with treatment services?

Check out: Public Health Project Topics with Materials