Factors Impacting Viral Load Suppression in Children and Adolescents Living with HIV Enrolled in an Orphans and Vulnerable Children Program in Northeast Nigeria.

Abstract

Introduction: There is limited research on factors impacting viral load suppression among children and adolescents living with HIV (CALHIV) in low-income countries. The objective of the study was to determine and analyze factors affecting HIV viral suppression levels among CALHIV enrolled in the Integrated Child Health and Social Services Activity (ICHSSA 4) Orphans and Vulnerable Children (OVC) project in Northeast Nigeria.

Methodology: The study adopted a descriptive cross-sectional research design for the study. The study involved collecting data among 847 CALHIV aged 0 to 17 years, enrolled in USAID-supported healthcare facilities across 9 Local Government Areas (LGAs) in Adamawa, Bauchi, and Taraba States. Prevalence of viral load suppression was described by child/adolescent, caregiver-related factors. Mixed-effects multivariable logistic regression models were fitted to explore the factors associated with viral load suppression.

Results: CALHIV enrolled on the ICHSSA-4 project >2 years (92.7%) had better suppression levels compared to those 1 year and less (7.1%). About 94.5% of CALHIV who adhered to prescribed ARV medication were transitioned to pediatric ARV optimal regimen achieved viral suppression. Psychosocial factors such as the presence of treatment support person, enrolment in an age-appropriate support group, and positive HIV disclosure status also impacted viral load suppression positively. The sociodemographic, health/clinical, and psychosocial factors affecting viral load in CALHIV enrolled on the project were found to be statistically significant (p < 0.05).

Conclusion: The study found that factors such as CSO OVC services provided to households, adherence support, food sufficiency in the household, attendance at support groups, treatment literacy and other social services influence viral load suppression. Identifying these factors can help monitor and improve treatment outcomes among CALHIV enrolled in an OVC programs and surely accelerate progress towards achieving the UNAIDS 3rd 95 goal.