Outcome Evaluation of the HIV Care Cascade in the Abidjan Health Region in Côte D’ivoire

Abstract

Background Around 80 to 90% of new HIV infections are due to PLHIV undiagnosed or diagnosed and yet not retained in care. There are few findings on the evaluation of the HIV Care Cascade in Western African countries. The objective of this study was to evaluate the HIV Care Cascade in the Abidjan Health Region in Côte d’Ivoire and the achievement of the 90 90 90 targets in 2018. Methods The study location was the Abidjan Health Region. I used data from the SIGDEP2, French acronym for an Electronic Patient Record Management Information System. A cross-sectional and longitudinal cascade analysis were used. Factors associated with Viral Suppression analysed by a logistic regression model. MS Excel 2016 and Stata version 15 were used for the analysis. Results In the HIV Care Cascade, there were 31,182 PLHIV, 23,895 (76.6%) were women and 22,314 (71.6%) were between 25 and 49 years old. Considering the number of PLHIV in the HIV Care Cascade, 24,247 (83 %) were linked to care, 22,280 (92%) of those linked to care started ART, 20,708 (93 %) of those on ART were retained in care and 11,944 (58%) of those on ART achieved Viral Suppression. Considering the number of PLHIV newly diagnosed from 2014 to 2018 which is 17,294, 15,839 (92%) were linked to care, 12,931 (75%) started ART, 12,207 (71%) were retained in care and 5,932 (34%) achieved Viral Suppression. The ages between 20 and 24 years old (AOR= 0.63 ; 95% CI [0.43 - 0.94]), between 25 and 49 years old (AOR= 0.71 ; 95% CI [0.60 - 0.84]), over 50 years old (AOR= 0.71 ; 95% CI [0.60 - 0.84]), the marital status single (AOR= 0.84 ; 95% CI [0.72- 0.98]) and married (AOR= 0.84 ; 95% CI [0.71 - 0.99]), tertiary school education (AOR= 1.50 ; 95% CI [1.15 - 1.95]) were more likely to have Viral Suppression. Conclusion Among PLHIV diagnosed, linkage and Retention in Care are effective. Gaps observed in the cascade is with ART coverage and Viral Suppression which should be intensified.