Résumé
Despite considerable progress in the scale-up of antiretroviral therapy programs in Cameroon, disparities persist between urban and rural settings. Understanding the characteristics of rural populations is crucial for designing effective, context-specific interventions that address barriers to early HIV care engagement. A retrospective cohort study was conducted of all HIV infected adults who initiated ART at 10 rural ART clinics in the Centre Region of Cameroon between June 2020 and May 2021. Patients’ medical records were reviewed for data collection. Of the 2 591 HIV infected adults included in the analysis, 983 (37.9%) were males and 1 608 (62.1%) females. Mean age at initiation was 38.91 ± 11.41 years with statistically significant difference between genders (p = 0.0002). A higher percentage of females (34.8%) initiated care in the 21-30 years age group than males (18.6%) (χ² = 87.163, p < 0.0001). More females initiating ART had no formal education (10.3%) or primary education (42.3%) compared to their male counterparts (8.1% and 40.7%, respectively) (χ² = 13.213, p=0.021). Females (56.7%) were more likely not to disclose their HIV status to their partners than males (53.2%) (χ² = 9.380, p = 0.009*). Moreover, more females (71.1%) compared to males (41.1%) initiated ART with TDF/3TC/DTG (χ² = 35.509, p < 0.0001*). The findings from the study show the complexity of demographic, behavioural and clinical factors influencing ART engagement emphasising the importance of tailored interventions to address the unique challenges faced by both males and females during this critical phase of care.