Factors associated with virological non-suppression after enhanced adherence counselling among people living with hiv on antiretroviral therapy in Kigoma Ujiji municipal

Abstract

ABSTRACT Background Introduction. The UNAIDS 90–90-90 strategy stipulates that 90% of all people on (ART) should have a suppressed viral load after enhanced adherence counselling. However, despite the introduction of enhanced adherence counselling to people living with HIV on ART whose viral load suppression has failed, yet there are some cases where viral load suppression has failed. Objective To determine factors associated with virological non-suppression after enhanced adherence counselling among people living with HIV on ART in Kigoma Ujiji Municipal Council. Methods: A cross-sectional study design employing a quantitative approach was done for people living with HIV on ART who had their viral load measured between July and December 2018. The study involved retrospective reviewing of information on the factors associated with virological non-suppression among people living with HIV on Antiretroviral therapy in Kigoma Ujiji. Raw data were entered and cleaned in SPSS version 24. Factors associated with virological non-suppression were determined through multivariable logistic regression. To control for possible confounders factors with p-value<0.2 in the bivariate analysis was further entered into the multivariate analysis. Adjusted odds ratio with 95% confidence interval were used to establish an association between predictor variables and dependent variables. Results: The study was composed of 460 patients; of these, 402(87.4%) had suppressed viral load while 58 (12.6%) had an unsuppressed viral load. Virological non-suppression was higher, among patients in 2nd line of ART treatment (AOR: 1.181(0.557-2.503), among patients with more than 4 weeks’ time interval from HIV diagnosis to ART initiation (AOR:2.831(1.455-3.963), among patients with 2 years and above on ART treatment (AOR: 1.698(0.899-3.205) and among patients with no previous ARV exposure (AOR: 1.698 (0.899-3.205) Conclusion This study found the prevalence of virological non-suppression in Kigoma Ujiji was 12.6%, with From this study, male, history of non-communicable diseases, poor treatment adherence, history of TB Co-infection and incorrect dosing schedule being the factors strongly associated with virological non-suppression.