Authors
Teshome Nadew, Tadesse Mamo Dejene, Abraraw Gebre, Abinet Dagnaw & Akine Eshete
Abstract
Background
Persistent enhanced adherence counseling (EAC) is necessary to improve adherence and achieve viral load suppression, particularly for clients with a viral load above 1000 copies/ml. The main aim of the study is to assess the magnitude of viral load suppression after EAC and associated factors among ART clients.
Methods
A retrospective study was conducted using institutionally recorded data from July 2018 to June 2023. The study incorporated 409 records of people living with HIV (PLHIV) who were enrolled in EAC. They were selected using the random sampling technique. Data were collected using the Kobo Collect toolbox, and Stata 14.1 software was used for the analysis of exported data. Using binary logistic regression, the contributing components were identified. Variables with a p-value less than 0.25 during crude analysis were included in the multivariable logistic regression. Then, an odds ratio with 95% CI was utilized, and a p-value < 5% was used to identify factors.
Result
Viral load suppression rate after EAC were 64.3%, with a 95% CI (59.3–68.5). Experiencing poor drug adherence (AOR 0.21, 95% CI = 0.117–0.41), being a single (AOR 0.330, 95% CI = 0.18–0.63), being in rural resident (AOR 0.35, 95% CI = 0.202-0.60), having a history of alcohol consumption (AOR 0.53, 95% CI 0.286–0.98), and chewing khat (AOR 0.22, 95% CI = 0.09–0.54) were affecting the viral load suppression in this study.
Conclusion
The unsuppressed viral load after EAC was associated with alcohol usage, khat chewing, marital status, poor adherence, and place of residence. The WHO target of 70% viral load suppression was not met. Thus, this study recommends that case managers, adherence counselors, and multidisciplinary teams at medical facilities prioritize clients with low adherence and address behavioral variables to optimize viral load suppression.
