Determinants of viral load suppression among orphaned and vulnerable children living with HIV on art in Tanzania

Abstract

Background: In Tanzania, only 18.4% of children on Antiretroviral Therapy are virally suppressed. Although retention on ART and poor adherence remain a challenge for children living with Human Immunodeficiency Virus, Orphans and Vulnerable Children (OVC) face a greater limitation of access to and utilization of comprehensive care and treatment. In response to this, the current study assessed the determinants of Viral Load Suppression among OVC aged 0-14 years living with HIV enrolled in HIV interventions. Methodology: This was a cross-sectional study that used secondary data from a USAID Kizazi Kipya project from 81 councils of Tanzania. Included in this study are 1,980 CLHIV (0-14 years) enrolled and served by the project for 24 months. Data analysis involved multivariate logistic regression, with viral load suppression as the outcome of interest and HIV interventions as the main independent variables. Results: The overall viral suppression rate among the OVC was 85.3%. This rate increased from 85.3%, 89.9% to 98.8% after 6, 12, and 24 months of retention on ART, respectively. Similar rates were observed as the duration of adherence to ART increased. In the multivariate analysis, OVC attending People Living with HIV groups were 411 times more likely to be virally suppressed than those not attending (aOR = 411.25, 95% CI 168.2–1005.4). OVC enrolled in Community Health Fund (CHF) were 6 times more likely to achieve viral suppression than those without (aOR = 6.05, 95% CI 3.28–11.15). Other significant factors included food security and family size. Conclusion: CLHIV reached by the different HIV community-based interventions were more likely to be virally suppressed than those who were not. To advance viral suppression, efforts should be made to ensure that all CLHIV are reached by the interventions as well as integrating food support in HIV treatment interventions.