Factors associated with viral non-suppression among HIV-positive young people who received intensive adherence counseling in high-volume health facilities

Abstract

Introduction: Viral non-suppression is defined as viral load ≥1000 copies/ml according to WHO guidelines. Viral non-suppression among patients on ART is important for timely detection of treatment fai1ures, and 1dentification of patients who need to enhance adherence counselling. Within a year of attaining the “90- 90-90” target, current records show that 53% of people living with HIV (PLWH) have viral non-suppression worldwide. In Uganda, approximately 40% of the people living with HIV on HIV treatment have viral non-suppression. Objective: The objective of the current study was to assess factors associated with HIV viral non suppression among young people who underwent intensive adherence counseling in high volume health facilities of Kyenjojo district, mid-western Uganda. Methodology: Analytical cross-sectional study design utilizing quantitative method which was conducted among 162 young people who had received intensive adherence counseling in selected high volume health facility were randomly selected from one hospital, a health center IV, and four randomly selected Health center III. The participants completed a structured questionnaire which was in English and translated in Lutooro. Data was collected by administering pretested structured questionnaires by trained research Assistants. Data was single -entered and analyzed using statistical software version 22 for analysis. Frequency tables and graphs were used to describe the study variables. Bivariate, univariate and multivariate Logistic regression analysis methods were used to identify factors associated with viral non-suppression. Variables with P-value of <0.05 with 95% CI were used to declare statistical significance. Results: From the 162 adolescents who had completed comprehensive adherence counseling, level of viral load non-suppression was high at 55.6%. Having secondary education (AOR=0.243, p=0.034), having good ART adherence (AOR=0.290, 95% CI (0.105, 0.806), p=0.018) and being on second line treatment (AOR=1.704, 95% CI (1.465, 6.245), p=.0218) were independently associated with viral non-suppression. Recommendations: Therefore the study recommends that Adherence is imperative for viral suppression and should be assessed at every visit to identify and address possible barriers to adherence among HIV positive young people who underwent intensive adherence counseling. There is also need for further investments in enhancing adherence support among HIV positive young people on ART such as trained adherence counsellors to help improve viral suppression and barriers to adherence should be identified and addressed for all HIV positive young people before switching to second-line therapy