Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling-What Can We Learn About Its Factors?
Tanzania
factors
intensified adherence counseling
people living with HIV
virological failure
Journal
Infection and drug resistance
ISSN: 1178-6973
Titre abrégé: Infect Drug Resist
Pays: New Zealand
ID NLM: 101550216
Informations de publication
Date de publication:
2023
2023
Historique:
received:
03
11
2022
accepted:
06
03
2023
medline:
7
4
2023
entrez:
6
4
2023
pubmed:
7
4
2023
Statut:
epublish
Résumé
Introduction and expansion of antiretroviral therapy (ART) have turned the tide of HIV pandemic, thus helping people living with HIV (PLHIV) achieve viral suppression. This success may need to be complemented by intensified adherence counseling (IAC) to improve adherence to treatment. However, some PLHIV still face higher than acceptable viral loads despite being on treatment. We investigated the factors associated with the failure to suppress HIV viral load after three months of IAC sessions. This cross-sectional study analyzed secondary data from PLHIV-attended care and treatment clinics in Mwanza between January 2018 and December 2019 who had unsuppressed VL after being on ART for at least six months. We identified PLHIV in first-line ART with viral load evaluation before receiving IAC and had viral load results done at 90 days after IAC. We conducted descriptive statistics to examine the magnitude of viral suppression. Wilcoxon signed-rank test used to compare the median viral load before and after IAC sessions, and logistic regressions predicted the factors associated with failure. This study included 212 subjects. After intervention, most participants 85.9% (182) had significantly improved adherence compared to baseline. More than half 75.5% (160) of the participants had viral suppression after the intervention. Participants aged 18-25 years (AOR = 5.6, 95% CI, 1.1-29.6), unstable client during ART initiation (AOR = 0.3, 95% CI, 0.13-0.62), and poor adherence to ART (AOR = 4, 95% CI, 1.3-12.3) remained the main predictors of virological failure after IAC intervention. Even though virological suppression is influenced by ART adherence, the findings in this study have shown co-existence of other factors to be addressed. Unstable during ART initiation is a new factor identified in this study.
Sections du résumé
Background
UNASSIGNED
Introduction and expansion of antiretroviral therapy (ART) have turned the tide of HIV pandemic, thus helping people living with HIV (PLHIV) achieve viral suppression. This success may need to be complemented by intensified adherence counseling (IAC) to improve adherence to treatment. However, some PLHIV still face higher than acceptable viral loads despite being on treatment.
Purpose
UNASSIGNED
We investigated the factors associated with the failure to suppress HIV viral load after three months of IAC sessions.
Patients and Methods
UNASSIGNED
This cross-sectional study analyzed secondary data from PLHIV-attended care and treatment clinics in Mwanza between January 2018 and December 2019 who had unsuppressed VL after being on ART for at least six months. We identified PLHIV in first-line ART with viral load evaluation before receiving IAC and had viral load results done at 90 days after IAC. We conducted descriptive statistics to examine the magnitude of viral suppression. Wilcoxon signed-rank test used to compare the median viral load before and after IAC sessions, and logistic regressions predicted the factors associated with failure.
Results
UNASSIGNED
This study included 212 subjects. After intervention, most participants 85.9% (182) had significantly improved adherence compared to baseline. More than half 75.5% (160) of the participants had viral suppression after the intervention. Participants aged 18-25 years (AOR = 5.6, 95% CI, 1.1-29.6), unstable client during ART initiation (AOR = 0.3, 95% CI, 0.13-0.62), and poor adherence to ART (AOR = 4, 95% CI, 1.3-12.3) remained the main predictors of virological failure after IAC intervention.
Conclusion
UNASSIGNED
Even though virological suppression is influenced by ART adherence, the findings in this study have shown co-existence of other factors to be addressed. Unstable during ART initiation is a new factor identified in this study.
Identifiants
pubmed: 37020794
doi: 10.2147/IDR.S393456
pii: 393456
pmc: PMC10069435
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1885-1894Subventions
Organisme : FIC NIH HHS
ID : R25 TW011227
Pays : United States
Informations de copyright
© 2023 Mundamshimu et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
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