Epidemiology of HIV in Remote Equatorial Regions of Cameroon: High Prevalence in Older Adults and Regional Disparities

Data on HIV prevalence in remote, rural communities of Cameroon are scarce despite the country's high HIV-1 group M diversity. This study assessed HIV seroprevalence and socio-demographic determinants in four regions of the equatorial rain forest location of the country. A cross-sectional survey was conducted among 5,631 individuals in rural communities of the Centre, East, Littoral, and South regions. HIV testing was performed, and socio-demographic data were collected. Prevalence ratios (PR) and adjusted prevalence ratios (aPR) were estimated using bivariate and multivariate analyses. Overall, HIV prevalence was 3.4% in individuals aged 15–49 years and 4.9% in those aged ≥50 years. Women had higher prevalence than men (4.5% vs. 3.0%, aPR = 1.48, 95% CI:[1.26, 1.74], p< 0.001); and also, higher HIV prevalence among individuals aged 50-54 years compared to those aged 15-19 years (5.5% vs 1.8%, aPR=2.47, 95% CI: [1.63, 3.74], p< 0.001). The South region recorded the highest prevalence (5.2%, aPR=2.27, 95% CI: [1.65, 3.13], p< 0.001) compared to the Centre region with the lowest (2.3%). Divorced/separated/widowed individuals (10.2%) had increased risk (aPR=2.16, 95% CI: [1.48, 3.16], p< 0.001) compared to single individuals (3.2%). HIV remains a significant public health concern in remote rural Cameroon, with disproportionate impact on older adults and women. Surveillance should extend beyond the traditional 15–49 years age range, and targeted prevention is needed for high-prevalence regions and older populations to curb ongoing transmission.