Factors associated with viral load suppression and indicators of stigma among people living with HIV in Dar es Salaam tertiary hospitals, Tanzania.

Abstract

ABSTRACT The perception of stigma can contribute to virological failure among people living with HIV (PLHIV). This study was conducted to find out how stigmatization and self-stigma affect the ability of people living with HIV (PLHIV) in Dar es Salaam, Tanzania, to keep their viral load down. This was a hospital-based cross-sectional study conducted in Temeke Regional Referral Hospital (RRH) and Amana RRH at the Care and Treatment Clinic (CTC) between July and August 2020 using a structured questionnaire with open- and close-ended questions. Multivariate logistic regression analysis was used to examine the factors of viral load suppression. The Chi-square test was used to compare the factors of stigmatization and viral load suppression. Altogether, 406 PLHIV participated, with the most being female respondents, 298 (73.2%). The majority (50%) were aged between 25 and 44 years, whereas 171 (42.5%) respondents were married. Most of the participants, 382 (94.6%), were on a dolutegravir-based regimen, with the majority, 215 (52.8%), having a refill interval of three months. Most respondents, 379 (93.1%), disclosed their status. Most participants, 355 (87.4%), preferred having a separate HIV clinic, while 130 (32.1%) participants were not ready to be attended by the health care workers (HCWs) familiar to them. Male patients were 60% less likely to suppress their viral load as compared to female patients (adjusted odds ratio [aOR]: 0.4, 95% confidence interval [95%]: 0.19–0.77, p-value = 0.007). The refill interval was significantly associated with viral load suppression. For example, patients with a one-month refill interval had odds of 0.01 (95% CI: 0.003–0.42, p-value = 0.0001) compared to six-month refill intervals. Stigmatization elements appeared to influence viral load suppression among PLHIV in the Dar es Salaam area, significantly predicting viral load outcomes when gender and time between refills were considered. Keywords: self-discrimination, stigmatization, Dolutegravil, Dar es Salaam, HIV, viral load suppression, people living with HIV, Tanzania