In this interview, we discuss with Dr. Bonheur Dounebaine, co-author of the article Social behaviors and HIV risk factors among men in Chad and Cameroon published in the  PAMJ.

Bonheur Dounebaine, MD, MPH Medical Epidemiologist, Atlanta, Georgia (USA)

Congratulation on your paper and thank you for choosing the PAMJ to publish your research.

Thank you.

Can you tell me a little bit more about yourself and your areas of practice or research?

My name is Bonheur Dounebaine, I am a trained medical doctor and epidemiologist. I have almost ten years of professional experience working in developing countries on disease surveillance, HIV/AIDS, immunization/polio eradication programs, health communication (C4D), and reproductive health with international institutions including UNICEF and the World Health Organization (WHO). For the last three (3) years, I was involved in research and fieldwork looking at the best health care delivery systems in developing countries.

Can you explain your choice to explore HIV among men?

HIV/AIDS remains among the top killers in Sub-Saharan Africa among both men and women, and most studies focus on the general population or mother-to-child transmission. However, men are also responsible for the transmission of HIV to women (vice versa) in Sub-Saharan Africa, therefore understanding the social behaviors of men could also help frame the health policies and programs.

Your paper explores behavioral factors associated with HIV among men that might explain the difference in the national HIV prevalence in two neighboring countries of Cameroon and Chad. What motivated you to conduct that research?

Chad and Cameroon have respectively one of the lowest and highest HIV prevalence rates in Central Africa. Having spent my childhood in both countries (my hometown is at the border between the two), I wanted to understand why the two countries have contrasting HIV prevalence. Also, HIV among men in Chad is rarely addressed in the published literature, there are only a few publications from Cameroon.  So, the goal of our study was to explore behavioral factors associated with HIV among men in both countries that might explain the difference in the national HIV prevalence.

Can you summarize for our non-medical audience the findings of your study?

In conclusion, we found that condom use and HIV testing rates were very low among Chadian men compared to Cameroonian men but were higher among educated men and wealthy men in both countries. Also, knowledge about HIV was higher among men in Cameroon compared to men in Chad. However, Cameroonian men were more involved in multiple sexual partners and extra-marital relationships than Chadian men. Thus, government and partners could support more research and campaigns that aim at reducing multiple sexual partnerships – and/or HIV risk within those partnerships via condoms and HIV Treatment as Prevention - among the communities in Cameroon. 

Self-reported extramarital partners (A) and total lifetime (B) sexual partners among men in Chad and Cameroon (Dounebaine et al. PAMJ. doi: 10.11604/pamj.2021.38.331.27237)

Were you surprised by some findings of your study?

Having spent a substantial amount of time in both countries and having worked as a disease surveillance officer in Chad, I was not surprised by the findings on literacy, testing, knowledge about HIV in both countries, etc. What I didn’t know was the difference in the multiple sexual partnerships among men in those two countries.

Publishing in a medical journal is the first step. How do you intend to further disseminate the findings of your study?

I look forward to presenting at the national and international conferences, symposiums, etc. but right now with COVID-19 most of those events are online or postponed, but I will present these findings.

What are your next steps in steps of advancing research on this subject?

First, our findings suggest that there is a crucial need to encourage HIV screening and testing among Chadian men, especially in rural areas. Testing also needs to be increased in Cameroon to meet the first UNAIDS target.

In Cameroon, the dominant risk factor for HIV was multiple sexual partners. There is a need for further research on this subject in Cameroon and for increased efforts to reduce multiple concurrent partnerships and/or reduce the risk of those partnerships through consistent condom use and timely initiation of ART for treatment-as-prevention in the communities.

How would you like policymakers to use the findings of your paper?

First, our findings suggest that there is a crucial need to encourage HIV screening and testing among Chadian men, especially in rural areas. Testing also needs to be increased in Cameroon to meet the first UNAIDS target.

The government in both countries should focus more on HIV literacy among rural communities, and the program should encourage men to participate in antenatal visits with their wives because HIV counseling and screening is already incorporated in the antenatal visits in both countries.

What motivated you to publish in an African Journal and, more specifically in the PAMJ?

I wanted our findings to be accessible to African audiences and policymakers, therefore publishing in an African journal makes more sense. Choosing the PAMJ is justified by the fact that it is an open-access journal, meaning that people can access our article through a simple internet search without paying a fee. Also, the PAMJ has a reputation in Africa now, it can compete with any international journal, finally, I believe it is time for African researchers need to start promoting and trusting African journals and institutions. 

Any final words to researchers thinking of publishing African-based research findings?

I think we need to build and support our own institutions, findings that are specific to Africa must be first disseminated within Africa, then to the outside audience, and the PAMJ being part of the PubMed and other international platforms, does a good job by providing those service. 

Thank you, Dr. Dounebaine, for this interview, and good luck with your work.

References

Bonheur Dounebaine et al. Social behaviors and HIV risk factors among men in Chad and Cameroon. Pan African Medical Journal. 2021; 38:331. doi: 10.11604/pamj.2021.38.331.27237