Sunday, April 11, 2010

Universal Access and YPLWHIV - Cameroon study (Know your Epidemic Part B)

For almost three decades now, the Human immunodeficiency Virus (HIV) pandemic has remained one of the most complex health issues among human beings especially the young people allover the world. The joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that 5.4 million youths aged 15-24 were among the likely 33 millions people living with HIV in 2007. Allover the world, young people have never known a world without HIV especially as an estimated 7500 people are still being infected with the virus everyday (UNAIDS 2007).

Sub Saharan Africa is home to two-third of young people living with HIV and most of these youths also belong to marginalized populations that are vulnerable to HIV such as sex workers and men who have sex with men (MSM).

Cameroon is one of the sub-Saharan African countries and home to about 540 000 people living with HIV (15-49 years) – meaning 5.1% of the country’s population is infected (UNAIDS 2008). Youths especially young women (15-24 years) are believed to be two times more infected than any other generation.

To contain the HIV infection, the Cameroon Government has endorsed most of the international treaties that allows universal access to HIV prevention, treatment care and support including the protection of the rights of people living with HIV and AIDS (PLWHIV).Cameroon is signatory to the Millennium Development Goals, UNGASS Declaration of Commitment; the Maputo protocol (not yet ratified to law) and the CEMAC Policy on Mainstreaming HIV/AIDS in Primary and Secondary Education programmes.
It is within this framework that the Cameroon government developed the National AntiRetroviral Treatment (ART) program which has covered about 58% of the estimated eligible HIV infected population by June 2008 (Elsevier Health volume 92, October 2009).

However, young people and male patients, as well as those who only had a primary level education are less likely to access ART at Central and Regional Hospitals, whereas those who are unemployed are less likely to be treated at all. Patients are less likely to be treated in Central and Regional hospitals with higher workload per medical staff member and absence of task shifting policy, and in district hospitals with non-availability of equipment for CD4 counts and larger size (150 beds or more) -.(Elsevier Health volume 92, October 2009)

Young people living with HIV (YPLWHIV) do not only deny access to ART especially in the urban areas but also refrain from joining Support Group and coming out to lead HIV and AIDS activities. According to the report of a project carried out by Cameroon National Association for family Welfare (CAMNAFAW) in 2009/2010, young people constitute less than 5% of the membership of Social support Groups aimed at promoting care and support to PLWHIV; and out of every ten members, 8 are women against 2 men.

Following consultations with Associations of PLWHIV, Treatment Center, SCO working with PLWHIV and Members of the Ministry of Public Health, accountability for the poor access to HIV treatment, care and support by YPLWHIV can be examined at the level of service delivery, societal beliefs and the economic policies in Cameroon. It should be noted that, the AIDS Accountability Card scores Cameroon's Treatment effort as low (2/5).

At the level of service delivery, the treatment centers have limited workforce and infrastructures. Because of the increasing workload on the limited personnel providing services at the treatment centers, stress provoke some of them to say words that creates a feeling of stigma in the clients. At times, this also results into bribery and corruption that works at the detriment of the poor youths.

Still at the treatment centers, the infrastructure does not permit adequate confidentiality especially in structures with multipurpose rooms (one room for reception and/or pre-test and post test counseling) and feebly separated rooms. The beddings infrastructures in the Central and Regional Treatment Centers are usually limited in space.

In many cases, the service providers have limited time to properly counsel the clients. Most of them don’t even have time and opportunity to acquire updates about living positively with HIV. Thus, limited positive living education wreck hope for the YPLWHIV and builds a self stigma which further prevents them from accessing treatment, care and support.

Societal beliefs paint the HIV infected youths as promiscuous and ungodly and thus, YPLWHIV would prefer to hide and die with HIV than to access treatment, care and support where they would be stigmatized.

Economic factors are also accountable for poor access by YPLWHIV. Immediate survival is considered more important than belonging to a Support Group. Since youth unemployment in Cameroon stands at 13%, the rush for limited resources for survival often undermine the need for educational and psycho-social support. Poverty also limits that young people from paying for regular health cheeks.

In conclusion, the government is held accountable for not providing: enough personnel to render services; adequate infrastructures; recycle programmes for personnel and jobs for youths. The community is also held accountable for promoting negative beliefs about HIV and stigmatizing YPLWHIV.


Resources

• World AIDS campaign : http://www.worldaidscampaign.org/en/
• The Joint United Nation programme On HIV and AIDS (UNAIDS): http://www.unaids.org/en/CountryResponses/Countries/cameroon.asp
• Essevier.Journals : http://www.journals.elsevierhealth.com/periodicals/heap/article/S0168-8510%2809%2900075-X/abstract
• CEMAC HIV policy: http://unesdoc.unesco.org/images/0017/001785/178583E.pdf
AiDS accountability score cared: http://aidsaccountability.org/?page_id=1369/

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