Decentralization of access to antiretroviral therapy in Cameroon: correlates of HIV physicians' knowledge in HIV care

Rasson, Sophie, Boyer, Sylvie, Fugon, Lionel, Protopopescu, Camelia, Marcellin, Fabienne, Koulla-Shiro, Sinata, Kouanfack, Charles, Spire, Bruno, Moatti, Jean Paul, Carrieri, Maria Patrizia, The EVAL Study Group, and Fisher, Martin (2011) Decentralization of access to antiretroviral therapy in Cameroon: correlates of HIV physicians' knowledge in HIV care. Antiviral Therapy, 16 (3). pp. 423-428. ISSN 2040-2058

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Good knowledge in HIV care among physicians is a necessary prerequisite to effective antiretroviral therapy (ART) scaling-up in Sub-Saharan Africa.


Between September 2006 and March 2007, a 27-item knowledge questionnaire was proposed to all HIV physicians working in 27 hospitals throughout six provinces of Cameroon. Physicians' responses were compared between the three levels of decentralization of the Cameroonian healthcare delivery system (χ(2) and Fisher tests). Correct responses were summed to build a knowledge score. Factors significantly associated with a higher score were identified using linear regression.


In total, 93 physicians filled in the questionnaire. Level of knowledge was globally good (median score 23), with no significant difference between the three levels of decentralization. Gaps in knowledge were observed regarding the use of cotrimoxazole and the follow-up of ART-treated patients. Main factors independently associated with a higher knowledge score included training, involvement in therapeutic committees, satisfactory collaboration with other practitioners and establishment of strong relationships between patients and patients' associations.


Overall knowledge in HIV care is good among HIV physicians working at all three levels of decentralization of healthcare in Cameroon. However, a national training policy should be set up to improve knowledge and practices in both ART follow-up and specific situations such as paediatric HIV. Collaboration between caregivers and external resources involved in HIV care should also be encouraged.

Item Type: Article
Additional Information: Martin Fisher is not a named author on this journal article but is a member of the EVAL Study Group
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0643 Communicable diseases and public health > RA0644 Individual diseases or groups of diseases, A-Z > RA0644.A25 AIDS. HIV infections
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Depositing User: Ellen Thomas
Date Deposited: 14 Feb 2014 12:39
Last Modified: 14 Feb 2014 12:41
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