Determinants of viral load non-suppression among adult HIV positive patients on antiretroviral therapy in public health facilities in Ambo town, Ethiopia: A case-control study.

Abstract

Background: Viral non-suppression is still a major obstacle to putting an end to the epidemic, although Antiretroviral Therapy (ART) has made HIV a chronic illness that can be managed. Ethiopia has made strides, but there are still regional differences and particular structural obstacles that rural populations must overcome. The purpose of this study was to determine the factors that contribute to adult HIV-positive patients in public health facilities in Ambo town, Ethiopia, not having their viral loads suppressed.

Methods: A facility-based unmatched case-control study was carried out from March to May 2023. There were 376 participants in all (131 cases and 245 controls). Trained data collectors conducted secondary reviews of patient charts and electronic records in addition to structured interviews. Data were entered into EpiData version 3.1, then exported to SPSS version 26 for additional statistical analysis. Both bivariate and multivariable logistic regression analyses were performed. In the multiple logistic regression analysis, a p-value of less than 0.05 paired with a 95% confidence interval was utilized to determine statistical significance.

Results: According to the multivariable logistic regression analysis, marital status (AOR = 0.232, 95% CI: 0.065-0.830), complexity of the treatment regimen (AOR = 7.333, 95% CI: 3.357-16.017), treatment interruption (AOR = 2.298, 95% CI: 1.146-4.609), follow-up schedule (AOR = 3.721, 95% CI: 2.033-6.812), and adherence (AOR = 16.568, 95% CI: 5.587-49.129) were found to be significantly associated with the viral non-suppression.

Conclusion: Viral non-suppression in Ambo is primarily associated with behavioral and treatment-related factors, including poor adherence, high pill burden, and irregular follow-ups. One protective factor observed to have an inverse association is social support, particularly through marriage. A single-tablet regimen and improved adherence support systems, especially for a single group category patients, to meet the 95-95-95 targets.