Factors Associated with viral non-suppression among Adolescents Living with HIV at Lira Regional Referral Hospital (LRRH): A cross sectional analytical studyFactors Associated with viral non-suppression among Adolescents Living with HIV at Lira Regional Referral Hospital (LRRH):

Abstract

Purpose : WHO defines viral load non-suppression as viral load ≥1000 copies/ml. 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. Despite a continuing global trend of fewer AIDS-related deaths in children and adults, the opposite has occurred among adolescents aged 10-19 years. However, results on viral non-suppression among adolescents suggest that antiretroviral therapy outcomes for adolescents from both high-income and low-income settings tend to be worse than for adults. In Uganda, the proportion of viral non-suppression among adolescents countrywide is 27%. In Lira Regional Referral Hospital, almost 30% of these adolescent patients developed viral non-suppression within one year after starting antiretroviral therapy. This study aimed to investigate factors associated with viral non-suppression among Adolescents living with HIV at Lira Regional Referral Hospital (LRRH)

Methods: A cross sectional analytical study was conducted with a mixed methods approach on asimple random sample of adolescents living with HIV aged between 10-19 years attending the antiretroviral therapy clinic at LRRH. Data was collected using a researcher-administered questionnaire on health-facility, care-giver and behavioral factors associated with viral load non- suppression. 5 key informant interviews were also conducted to further understand viral load non-suppression among adolescents.

Results: The level of viral non-suppression was 69% with a mean age of 16.44 and standard deviation of 1.74. Females made up 55.5% of our respondents. Having lived with HIV/AIDS for 3-6 years (AOR: 4.28, 95% CI: 2.94-15.01, p-0.000) and being an alcohol consumer (AOR: 5.88, 95% CI: 2.78-11.85, p-0.009) were positively associated with viral load non-suppression. A positive attitude of health workers (AOR: 0.16, 95% CI: 0.08-0.46, p-0.002) and having received continuous counseling from the counsellor at the facility (AOR: 0.15, 95% CI: 0.09-0.55, p- 0.000) were independently negatively associated with viral non-suppression.

Conclusions: Viral load non-suppression was more likely if an individual was an alcohol consumer and less likely if the health workers had a positive attitude or were under continuous counselling from the counselor at the Healthy facility. At the Healthy facility, there is need to set up adolescent friendly clinics and ensure a positive attitude of health workers towards adolescents living with HIV. Key programs that support continuous counselling of adolescents living with HIV should also be set up at the facility to ensure that the Adolescents are supported.