School of Public Health - International Health
Cameroon-Implementation Research in the Continuum of HIV Prevention, Care and Treatment among men who have sex with men and female sex workers in Cameroon.
This work is being completed in parntership with several Cameroonian organizations as well as Care USA to improve HIV treatment outcomes among men who have sex with men and female sex workers in Cameroon.
Sex work and same-sex practices are illegal in Cameroon, however, these populations are specifically listed as priority groups in Cameroon's current National Strategic Plan for HIV, AIDS, and Sexually Transmitted Infections which lists priority actions such as strengthening HIV prevention programs and capacity building for HIV health services serving these populations. Recent studies established the need for integrating a comprehensive HIV prevention package into HIV care and treatment. In response, CARE USA who has been awarded a USAID grant to establish the Continuum of Prevention, Care and Treatment (CoPCT) of HIV/AIDS with Most at-risk Populations in Cameroon (CHAMP), has partnered with our team at JHU and Global Viral Cameroon (GVC) to complete a series of research projects to inform and evaluate their service delivery. This work will include : 1) Two rounds of integrated biological and behavior survey among men who have sex with other men, female sex workers and long distance truck drivers; 2) a two-year longitudinal study among men who have sex with othe men and female sex workers. The result of this study will help to better inform the delivery of services to these populations.
The specific objectives of this study are:
1) Establish a baseline risk behaviors, attitudes biological for future evaluation of CHAMP intervention, among MSM, FSW and LDTD population
2) Determine the point prevalence of HIV and Syphilis among adult FSW, MSM and LDTD (18 years of age and older) in the CHAMP intervention sites
3) Characterize the individual, network-level, and structural determinants of prevalent HIV infections and condom use among adult FSW and MSM in the CHAMP intervention sites
4) Measure the effectiveness of integration an comprehensive HIV prevention package into HIV care and treatment
5) Measure the effectiveness of intervention on HIV transmission risk behaviors
6) Understand structural barriers for key population to access services along the continuum of care
PI Mentor: Stefan Baral
The first time one of my coworkers at my GHEFP placement greeted me “c’est comment?” (a common way to say “how’s it going?”) I just smiled back silently. Wait, this wasn’t covered on my Duolingo app! Six months later, I could happily return the pleasantries, and even muddle my way through many of the conversations I needed to work with my (very patient) coworkers. Improving my French, while a valuable experience for me, was the tip of the iceberg of the learning opportunities that my GHEFP placement offered. Working at CHAMP through GHEFP gave me a broad view of how HIV programming for key populations works around the world and how non-profits, community organizations, local government, and national and international agencies collaborate.
During my placement, I was based at the Continuum of Prevention, Care and Treatment (CoPCT) of HIV/AIDS with Most-at-risk-Populations in Cameroon(CHAMP), which is a partnership between CARE Cameroon, JHU (specifically the Key Populations program at the Center for Public Health and Human Rights), and Metabiota. CHAMP is a PEPFAR-funded program that provides HIV prevention, care and treatment for key populations in Cameroon, including men who have sex with men and female sex workers. Working in a setting that does both public health programming and implementation research was a unique opportunity to see how research informs public health practice. My responsibilities during my placement touched on many parts of this process – I participated in discussions about studies in the planning phase; calculated HIV incidence rates from a recent cohort study; drafted guidelines for HIV self-testing, which will soon be rolled out for the first time in Cameroon; worked on reports and presentations; and supported the monitoring and evaluation team in developing new procedures for data visualization.
During my placement, I witnessed the challenges of providing HIV services to key populations: this work is challenging in any setting, particularly in a setting where stigma and discrimination are widespread, and can put program beneficiaries as well as staff – who are often members of key populations themselves – at risk. It can also be challenging to align the goals of researchers, service providers, local government institutions, and funders. But, during my placement in Cameroon, I also got the chance to meet and work with people standing up to these challenges at many levels: peer leaders, community activists, researchers, program coordinators and healthcare providers. The opportunity to meet and collaborate with this diverse community that challenges, inspires, and motivates was the best part of what GHEFP had to offer.
Me (5th from left) with the team during my last week of the placement