Abstract:
Background: Viral load is the amount of HIV ribonucleic acid in the blood of HIV-positive Peoples. For HIV-positive patients with high viral load counts, the World Health Organization recommends enhanced adherence counseling before switching to a second or third-line regimen. But despite improved adherence counseling programs, most countries fall short of the desired degree of viral load suppression after enhanced adherence counseling.
Objective: The aim of this study was to assess the proportion of viral suppression and its associated factors after enhanced adherence counseling among HIV positive adults with unsuppressed viral loads at public hospitals of West shoa zone, Oromia, Ethiopia 2023.
Methods: Institution-based cross-sectional study was conducted among 256 randomly selected HIV positive adults with unsuppressed viral loads on Anti-Retroviral Therapy between 2019 to 2022. Of 8 Hospitals (provide ART services), 50 % were selected randomly by lottery method and sample size were proportionally allocated to each selected Hospitals. Data were collected from Electronic Medical Record or smart care, patient’s chart, enhanced adherence counseling sheet and viral load related registers using data extraction tool. The collected data were entered into Epi data 3.1 then exported to SPSS 25 for cleaning, editing and analysis. Variables in the bivariate analysis having a p value < 0.25 were entered to multivariable binary logistic regression analysis model to identify factors associated with viral load suppression. The presence of statistical association was assessed using AOR with its 95% CI and P value < 0.05 was used to declare statistical significance.
Result: From 256 HIV positive adults with unsuppressed viral loads, 159 (62.1%) achieved viral suppression after enhanced adherence counseling. First high viral load between 50 to 5,000 copies/ml (AOR=2.047, 95%CI: 1.04, 4.02), taking TB preventive therapy(AOR=4.855, 95% CI: 1.21, 19.50), no history of opportunistic infections(AOR=2.09; 95%CI, 1.06, 4.12), being in 1-month DSD model(AOR=1.424, 95%CI: 1.02, 3.30), mental health illness(AOR= 0.262, 95% CI: 0.11, 0.63) and being student(AOR=3.806, 95%CI: 1.21, 11.96) were significant factors of viral load suppression.
Conclusion and Recommendation: Overall viral load suppression after enhanced adherence counseling is low as compared to WHO recommendation. Special attention should be given to unsuppressed patients, and they need to be managed separately at viremia clinic.
