HIV viral load suppression amongst the incarcerated populations in Cameroon

Abstract

INTRODUCTION: Despite increased national and international funding to combat the human immunodeficiency virus (HIV) pandemic, prison health services remain underfunded, resulting in poor HIV management among inmates. This study assessed viral suppression rates among HIV-positive inmates across four central prisons in Cameroon to evaluate the effectiveness of antiretroviral therapy (ART) in these settings. METHODOLOGY: This cross-sectional study included four central prisons-prisons A, B, C, and D-each located in different regions of Cameroon. Data were obtained from patient records, and blood samples were collected from inmates eligible for viral load (VL) testing. RESULTS: A total of 268 inmates receiving first-line ART were enrolled. The overall viral suppression rate, defined as VL < 1000 copies/mL, was 89.9%. The suppression rates in the four prisons were 94.25%, 87.69%, 78.95%, and 50% for Prison C, D, A, and B, respectively. There was a strong association between viral suppression and the specific prison (p < 0.001). Inmates on dolutegravir (DTG)-based regimens had significantly higher suppression rates (p = 0.027). Moreover, prisons supported by the United States President's Emergency Plan for Acquired Immunodeficiency Syndrome (AIDS) Relief (PEPFAR) reported better suppression outcomes compared to non-PEPFAR-supported facilities (X²(1) = 13.28, p = 0.000268). CONCLUSIONS: These findings underscore the disparities in HIV care across correctional facilities and highlight the need for harmonized clinical management of HIV in prisons. Ensuring equitable access to comprehensive HIV services is essential for achieving the 95% VL suppression target among incarcerated populations.