Viral load suppression among aAdolescents in HIV Care within primary health care facilities in Lubaga Division, Kampala Capital City Authority

Abstract

Background: Adolescents on ART should virally suppress within six months to live longer, boost immune system and reduce risk of HIV transmission . This study investigated VLS among adolescents in HIV care in primary health care facilities in Lubaga, Kampala Capital City Authority. Methodology: The study utilized cross sectional design. Study population included individual records of adolescents on ART with the 1st viral load result on file from 1st January 2017 to 31st December 2020. Data was analysed using univariate, bivariate and multivariable analysis to describe and establish associations. Logistic regression analysis was used to establish factors associated with the VLS. Results: Of the 196 records reviewed, the mean age of adolescents was 15(SD=4).The prevalence of VLS by the 1st viral load result was 64.3% (126/196). Duration on ART was statistically significant (aOR=0.10, 95%CI 0.04-0.26) while older adolescents (15-19) were more likely to suppress although not statistically significant (aOR 1.7; 95% CI 0.912-5.02). Only fifty seven percent (40/70) of the unsuppressed adolescents by the 1st viral load result were enrolled in IAC. However, only 62.5% (25/40) had viral load retest results in files; where only 60%(n=15/25) suppressed. Conclusion: Prevalence of VLS among adolescents on ART by the 1st viral load result was suboptimal; at 64% , younger adolescents have lower suppression rates., associated factor with reduced odds of VLS was spending one or more years on ART . VLS among adolescent enrolled on IAC was 60%. VLS whether by the 1st viral load result or after IAC was significantly lower than the global 95% target. IAC may offer some benefit to the initially unsuppressed adolescents who subsequently get enrolled onto this program. Recommendations: The fact that the proportion of VLS (60%) after IAC is similar to 64% suppression rate at six months shows that IAC may benefit unsuppressed adolescents. However due to a small sample size, we recommend that further studies be conducted to better understand the optimization of the success of IAC. Health Care providers should use a combination of ART adherence assessment methods to obtain a more accurate assessment of adherence while working with community health workers where they exist to obtain more information about the adolescent adherence behavior.