Background Partner services (PSs) are a long-standing component of HIV control programs in the United States and some parts of Europe. Small randomized trials suggest that HIV PS can be effective in identifying persons with undiagnosed HIV infection. However, the scalability and effectiveness of HIV PS in low-income countries are unknown. Methods We used data collected from 2009 to 2010 through a large HIV PS program in Cameroon to evaluate HIV PS in a developing country. HIV-positive index cases diagnosed in antenatal care, voluntary counseling and testing, and inpatient facilities were interviewed to collect information on their sexual partners. Partners were contacted via telephone or home visit to notify, test, and enroll those found to be HIV positive in medical care. Results Health advisors interviewed 1462 persons with HIV infection during the evaluation period; these persons provided information about 1607 sexual partners. Health advisors notified 1347 (83.8%) of these partners, of whom 900 (66.8%) were HIV tested. Of partners tested, 451 (50.1%) were HIV positive, of whom 386 (85.6%) enrolled into HIV medical care. An average 3.2 index cases needed to be interviewed to identify 1 HIV case. Conclusions HIV PS can be successfully implemented in a developing country and is highly effective in identifying persons with HIV infection and linking them to care.

Because of the known nutritional and health benefits to the infant, the World Health Organization recommends that women in resource-poor countries exclusively breastfeed until their babies reach 6 months of age. In the primarily rural geographical region of the North West Province of Cameroon, previous studies identified the prevalence of breastfeeding to be 90%. It is common knowledge that women are culturally encouraged to mix-feed their infants, but the extent of these feeding practices is not known. The objective of this study was to identify the extent of mixed feeding/supplementation and the cultural/social barriers to exclusive breastfeeding. All women surveyed introduced water and food supplementation prior to 6 months of age, with more than 38% giving water in the first month of life. Mothers identified cultural factors influencing their decision to mix-feed their babies, which included 1) pressures by village elders and families to supplement because it is a traditional practice, 2) belief that breast milk is an incomplete food that does not increase the infants weight, 3) belief that all family members should receive the benefit of food grown in the family farm, and 4) the taboo of prohibiting sexual contact during breastfeeding.

ANC surveillance indicates a decreasing trend in HIV prevalence in the studied sites in Cameroon. Cultural differences might have accounted for the heterogeneity of HIV infection observed across sites, which call for tailored interventions.

No abstract