Prevalence, Socio-demographic Correlates of Substance Use Disorders Among HIV-infected Adults in Cameroon, and Their Influence on Adherence to Antiretroviral Therapy and Immunological Feature: Study Protocol for a Retrospective Cohort Study

1. Introduction

1.1. Background

In low and middle income countries, 28.6 million people were eligible for antiretroviral therapy (ART) based on 2013 guidelines and only around 10 million were currently on ART. Cameroon is a lower-middle-income country with a prevalence of human immunodeficiency virus (HIV) infection in adults of 4.3% in 2011. In the same year, coverage for antiretroviral therapy in adults and children was 49.6%, demonstrating the immensity of the work to be done to achieve the goals of good ART coverage. The considerable expansion of access to HIV treatment in the world has changed the epidemic of HIV infection. The importance of ART is well established. Life expectancy of adults receiving ART is approximately 80% of the normal life expectancy. The preventive effect of ART is increasingly evident, even in cases where the HIV epidemic is concentrated.

There exists the link between alcohol consumption and infectious diseases, with the deleterious effect of alcohol on disease progression. In Cameroon, in general population, adult (15+ years) per capita alcohol consumption was 13.74 litters of pure alcohol. Heavy episodic drinking is 8.4% and 2.1% respectively among males and females in Cameroon in general population. Alcohol binge drinking was found in 11.6% of people living with HIV on ART and in 20.6% of those who were interrupted their treatment. Binge drinking was defined for male as consumption of 5 or more drinks, for female as consumption of 4 or more drinks, in about 2 hours. Alcohol use disorders screened with cutting down, annoyance by criticism, guilty feelings, eye-openers (cage) questionnaire are present among 17% of adults HIV-infected in Cameroon.

In Cameroon, the prevalence of non-adherence to ART was 22.5% based on the Community Programs for Clinical Research on AIDS index and 34.9% based on the Centre for Adherence Support Evaluation index. Alcohol is one of the main factors of ART interruption and ART non-adherence. The consumption of alcohol being on ART decrease response to highly active ART, and decrease health related quality of life.