Patterns and factors associated with unsuppressed HIV Viral load among adolescents in Taso Mulago and MJAP-ISS HIV Clinics from 2018 to 2022

Abstract

Introduction Human immune deficiency virus (HIV) suppression is the goal of antiretroviral therapy. Understanding the patterns and predictors of unsuppressed HIV viral load rates among adolescents was intended to information policy makers on how to design interventions to achieve the set targets of HIV viral load suppression in this sub population. This period 2018 to 2022 was chosen because of the introduction of dolutegravir based regimen and most of studies on unsuppressed viral load were conducted before this period. Objective The main objective of the study was to describe the patterns and factors associated with unsuppressed HIV viral load rates among adolescents in TASO Mulago and MJAP-ISS HIV clinics from 2018 to 2022. Methods The study was a retrospective cohort conducted among 1340 HIV positive adolescents attending TASO Mulago and MJAP ISS clinics from 2018 to 2022. The data on socio demographic, personal, psychosocial and clinical characteristics was extracted from the adolescent files using a data abstraction tool and then double-entered using EPI Data version 3.1 and then exported to Stata 14 for analysis. Numerical variables were summarized using means and standard deviations or median and interquartile range depending on the data if it were normally distributed or not. Categorical variables were summarized as proportions and presented as percentages and frequencies and mixed effects logistic regression was used for bivariate and multivariate analysis. xi Results The overall prevalence of HIV unsuppressed viral load for the study period was at 29% (95% CI 27--32%). [TASO-31 %( 95% CI 27--36%), MJAP--29 %( 95% CI 26--32%) ].The prevalence of unsuppressed HIV viral load based on: employment status was 35% (95%CI 27-45%) for those working versus 30% (95%CI 27-32) for those not working, 27% (95%CI 24-30%) for adolescents in school versus 38 %( 95%CI 33-44%)for those not in school, 32% (95%CI 29-37%) for males compared to 28% (95%CI 25-31%) in females, and 30% (95%CI 27-32%) in single adolescents versus 56% (95%CI 37-84%) in married adolescents.. The factors associated with unsuppressed viral load were: parents being alive (p-value<0.01), gender based violence (p-value<0.01), fair (p-value<0.01) and poor adherence (p-value<0.01).Conclusions.The prevalence of unsuppressed HIV viral load in this study population was high compared to global target. Efforts to improve viral suppression should target groups at high risk of having unsuppressed viral load like out of school or working male adolescents that have lost their parents,experiencing gender based violence, have fair and poor adherence on ART..