Determinants Of Viral Load Non-Suppression Among Adult Hiv Positive Patients On Antiretroviral Therapy In Public Health Facilities, Ambo Town, West Showa, Oromia, Ethiopia.

Abstract

Background: Non-suppressed viral load in patients on antiretroviral therapy occurs when treatment miss to reduce a person’s viral load less than 1000 copies/ml. During 2020 UNAIDS estimate, more than 66 thousand patients on antiretroviral therapy in Ethiopia is resulted in viral load non-suppression and associated with decreased in life expectancy and increased Human Immunodeficiency Virus transmission. Objective: The objective of study is to identify determinants of viral load non-suppression among adult Human Immunodeficiency Virus positive patients on antiretroviral therapy in Public Health Facilities of Ambo Town, West Showa, Ethiopia, 2022. Methods: An institutional-based unmatched case-control study was conducted from January 2022 to March 2022 on total 376 (131 cases: 245 controls) clients on Anti-Retroviral Therapy from January 2020 to December 2021 in Ambo town. Clients whose viral load result >1,000 copies/mL were cases, and < 1000 copies/ mL were controls. A simple random sampling technique was implemented to select cases and controls. Data were collected through pre-tested, structured questionnaire and secondary data extracted from patient records. All data were entered into computer using Epi data version 3.1 and then exported to SPSS version 26.0 for analysis. All variables having a P-value of < 0.25 in binary logistic regression were entered in to a multivariate logistic regression model to declare statistically significant at p value <0.05. Tables were used for result presentation. Results: Treatment discontinuation (AOR= 2.29, 95% CI: 1.15, 4.61), two and more treatment taken daily (AOR= 7.33, 95% CI: 3.36, 16.02), poor and fair adherence (AOR= 16.5, 95% CI: 5.59, 49.13) and 4.9 (AOR= 4.9, 95% CI: 2.61, 9.32), unscheduled follow up (AOR= 3.7, 95% CI: 2.03, 6.81), had significant association to HIV viral non-suppression. While Married (AOR= 0.23, 95% CI: 0.07, 0.83) and widowed (AOR =0.23, 95% CI: 0.06, 0.98) marital status less likely associated to HIV viral non-suppression. Conclusion: The risk of HIV viral non-suppression was increases among clients on ART. Treatment interruption, two and above treatment taken daily, sub optimal adherence and unscheduled follow up were had significant association to viral non-suppression. Hence, intensive working on enhanced adherence counseling, early tracing of loss to follow up, text notification and prescribing one tablet per day resulted in viral suppression.