Abstract:

In Cameroon, HIV prevalence among youths (15-24 years) is 2% and 26.5% of them have unwanted pregnancies. Sexual and reproductive health (SRH) services are widely available, whose optimal utilization will reduce these high rates of HIV/STI transmission and pregnancies, but their knowledge and uptake of these services are unknown. This study aimed to assess determinants of SRH knowledge and uptake among HIV-infected youths in the Northwest region of Cameroon. This cross-sectional study received administrative authorization from the Delegation of Northwest and CBCHB IRB approval (IRB2021-77). We sequentially sampled youths living with HIV and receiving care at 16 treatment sites. Data was anonymously collected from consented participants between February and April 2022 using a structured questionnaire. The data was analysed using Stata version 14.0. In total 340 participants were enrolled, 70% female, 62% within 15-19 age group. Overall, knowledge of participants on SHR services was 78% and its uptake was 58%. Knowledge was 71% for SRH counselling, 78% for pregnancy prevention, 78% for STIs services and uptake of these services was 78%, 70% and 76% respectively. Increased age positively predicted SRH knowledge while urban residence had a negative influence. Being a male, living in urban residence and not schooling was negatively associated with SRH service uptake while good SRH knowledge positively predicted uptake. The suboptimal level of knowledge, consistent with low service uptake suggests the need for more sensitization and education on SHR services which is key to influencing uptake of these services and consequently reducing unintended pregnancies and HIV/STIs transmission.

References:

[1] Adolescents_Living_with_HIV.pdf’. Accessed: Sep. 17, 2021. [Online]. Available: https://www.unicef.org/eca/sites/unicef.org.eca/files/2017-10/Adolescents_Living_with_HIV.pdf.

[2] H. Gebreyesus, M. Teweldemedhin, and A. Mamo, ‘Determinants of reproductive health services utilization among rural female adolescents in Asgede-Tsimbla district Northern Ethiopia: a community based cross-sectional study’, Reprod Health, vol. 16, no. 1, p. 4, Dec. 2019, doi: 10.1186/s12978-019-0664-2.

[3] COP-2020-Cameroon-SDS-FINAL (1).pdf’.

[4] 3471CAMPHIA_Cameroon-SS_A4_v13_requests_7.25.18.pdf’. Accessed: Dec. 12, 2022. [Online]. Available: https://phia.icap.columbia.edu/wp-content/uploads/2018/07/3471CAMPHIA_Cameroon-SS_A4_v13_requests_7.25.18.pdf.

[5] R. M. Fubam, N. Tendongfor, O. Olayemi, and A.-T. A. Odukogbe, ‘Sexual and reproductive health knowledge of secondary school adolescents in Fako, Cameroon’, The Pan African Medical Journal, vol. 41, no. 340, Art. no. 340, Apr. 2022, doi: 10.11604/pamj.2022.41.340.31686.

[6] B. E. Birhanu, D. L. Kebede, A. B. Kahsay, and A. B. Belachew, ‘Predictors of teenage pregnancy in Ethiopia: a multilevel analysis’, BMC Public Health, vol. 19, 2019, doi: 10.1186/s12889-019-6845-7.

[7] B. O. Ahinkorah et al., ‘Access to Adolescent Pregnancy Prevention Information and Services in Ghana: A Community-Based Case-Control Study’, Frontiers in Public Health, vol. 7, 2019, doi: 10.3389/fpubh.2019.00382.

[8] S. Lawrence et al., ‘“They Just Tell Me to Abstain:” Variable Access to and Uptake of Sexual and Reproductive Health Services Among Adolescents Living with HIV in Kenya’, Frontiers in Reproductive Health, vol. 3, 2021, Accessed: Sep. 13, 2022. [Online]. Available: https://www.frontiersin.org/articles/10.3389/frph.2021.644832.

[9] L. S. Mkumba, M. Nassali, J. Benner, and T. D. Ritchwood, ‘Sexual and reproductive health needs of young people living with HIV in low- and middle-income countries: a scoping review’, Reproductive Health, vol. 18, no. 1, p. 219, Nov. 2021, doi: 10.1186/s12978-021-01269-7.

[10] D. R. McCarraher et al., ‘Adolescents living with HIV in the Copperbelt Province of Zambia: Their reproductive health needs and experiences’, PLoS One, vol. 13, no. 6, Jun. 2018, doi: 10.1371/journal.pone.0197853.

[11] L. R. Ninsiima, I. K. Chiumia, and R. Ndejjo, ‘Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review’, Reproductive Health, vol. 18, 2021, doi: 10.1186/s12978-021-01183-y.

[12] T. N. Ndongmo, C. B. Ndongmo, and C. Michelo, ‘Sexual and reproductive health knowledge and behavior among adolescents living with HIV in Zambia: a case study’, Pan Afr Med J, vol. 26, Feb. 2017, doi: 10.11604/pamj.2017.26.71.11312.

[13] L. Vu et al., ‘Increasing Uptake of HIV, Sexually Transmitted Infection, and Family Planning Services, and Reducing HIV-Related Risk Behaviors Among Youth Living with HIV in Uganda’, Journal of Adolescent Health, vol. 60, no. 2, Supplement 2, pp. S22–S28, Feb. 2017, doi: 10.1016/j.jadohealth.2016.09.007.

[14] S. Okawa et al., ‘Sexual and reproductive health behavior and unmet needs among a sample of adolescents living with HIV in Zambia: a cross-sectional study’, Reproductive Health, vol. 15, no. 1, p. 55, Mar. 2018, doi: 10.1186/s12978-018-0493-8.

[15] V. Chandra-Mouli, A. Armstrong, A. Amin, and J. Ferguson, ‘A pressing need to respond to the needs and sexual and reproductive health problems of adolescent girls living with HIV in low- and middle-income countries’, Journal of the International AIDS Society, vol. 18, p. 20297, Dec. 2015, doi: 10.7448/IAS.18.6.20297.

[16] F. Sevidzem Wirsiy, D. S. Nsagha, O. Njajou, and J. Besong Besong, ‘Determinants of Sexo-Reproductive Health Needs of Adolescent Girls in the Kumbo West Health District of Cameroon’, J Environ Sci Public Health, vol. 03, no. 02, 2019, doi: 10.26502/jesph.96120057.

[17] Encouraging young people to access SRHR information’, Reproductive Health Supplies Coalition. https://www.rhsupplies.org/activities-resources/initiatives/whos-holding-up-our-pillars/cameroon-agenda-for-sustainable-development/ (accessed Sep. 13, 2022).

[18] Pregnancy and Associated Factors Among Adolescents and Young Adults Living with HIV in the Northwest Region of Cameroon’. https://www.fortunejournals.com/articles/pregnancy-and-associated-factors-among-adolescents-and-young-adults-living-with-hiv-in-the-northwest-region-of-cameroon.html (accessed Nov. 21, 2022).

[19] M. Loutfy, R. Khosla, and M. Narasimhan, ‘Advancing the sexual and reproductive health and human rights of women living with HIV’, J Int AIDS Soc, vol. 18, no. 6Suppl 5, Dec. 2015, doi: 10.7448/IAS.18.6.20760.

[20] T. N. Ndongmo, C. B. Ndongmo, and C. Michelo, ‘Sexual and reproductive health knowledge and behavior among adolescents living with HIV in
Zambia: a case study’, Pan Afr Med J, vol. 26, 2017, doi: 10.11604/pamj.2017.26.71.11312.

[21] M. Lowe, P. I. G. Sagnia, O. Awolaran, and Y. A. M. Mongbo, ‘Sexual and reproductive health of adolescents and young people in the Gambia: a systematic review’, Pan Afr Med J, vol. 40, p. 221, 2021, doi: 10.11604/pamj.2021.40.221.25774.