Antiretroviral Treatment (ART) initiation after a positive HIV test result is vital
for faster viral suppression. This study assessed the time to ART initiation and
factors associated to SDAI in the West region of Cameroon. This was a cross-sectional
retrospective study. The data was extracted from registers and patients’ medical
records and analysed. The mean age of the 3053 participants was 36.9 (SD: 13.3),
and 64.0% were female. A total of 2346 (76.8%) participants had initiated ART the
same day of the diagnosis. Female gender (OR= 1.2; 95%CI:1.1-1.5), Tier 3 HF (OR=
1.3; 95%CI: 1-1.7), semi-urban facility’s location (OR= 1.4; 95%CI: 1.1-1.7), periods
of test January-March 2020 (OR= 2; 95%CI: 1.6-2.6), April- June 2020 (OR= 1.7; 95%CI:
1.3-2.2), and July- September 2020 (OR= 3.4; 95%CI: 2.5-4.6), index case testing
entry point (OR= 1.6; 95%CI: 1.2-2.1), active occupational situation (OR= 1.3; 95%CI:
1-1.7), and good general status (OR= 1.3; 95%CI: 1.1-1.6) were independently associated
to same day initiation. In addition to WHO stage 2 (OR= 0.6; 95%), tuberculosis
(OR= 0.2; 95%CI: 0.1-0.5), inpatient (OR= 0.2; 95%CI: 0.1-0.4) and emergency entry
point (OR= 0.1; 95%CI: 0-0.2) were inversely associated to SDI. The ART initiation
was timely for most clients in the West region of Cameroon, in alignment with the
WHO recommendations. However, this was not the case among symptomatic, critically
ill, and tuberculosis clients. This underscores the need for ongoing support, counselling,
and continuous readiness assessment, as well as a strong linkage system for clients
with delayed ART initiation.
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