AIDS Research and Therapy | |
Determinants of viral load non-suppression among adolescents in Mbale District, Eastern Rural Uganda | |
Samuel Kizito1 Aduragbemi Banke-Thomas2 Ronald Makanga Kakumba3 Hajira Kataike4 Juliet Allen Babirye4 Rita Nakalega4 Joel Maena4 Cynthia Ndikuno Kuteesa5 Nelson Mukiza5 | |
[1] Department of Global Health, School of Public Health, Boston University, Boston, USA;Department of Public Health and Preventive Medicine, School of Medicine, University of Liverpool, Liverpool, UK;MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda;Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration Kampala, Kampala, Uganda;RineCynth Advisory Limited, Kampala, Uganda; | |
关键词: HIV; ART; Viral Load; Adolescents, ART, Non-suppression; Uganda; | |
DOI : 10.1186/s12981-021-00408-1 | |
来源: Springer | |
【 摘 要 】
BackgroundAdolescents are lagging behind in the “third 95” objective of the Joint United Nations Program on HIV/AIDS requiring 95% of individuals on antiretroviral therapy (ART) to have viral load (VL) suppression. This study aimed to describe factors associated with viral non-suppression among adolescents in Mbale district, Uganda.MethodsWe conducted a retrospective review of routinely collected HIV programme records. Data such as age, education, ART Regimen, ART duration, WHO Clinical stage, comorbidities, etc., were extracted from medical records for the period January 2018 to December 2018. Descriptive analysis was done for continuous variables using means and frequencies to describe study sample characteristics, and to determine the prevalence of outcome variables. We used logistic regression to assess factors associated with VL non-suppression among adolescents.ResultsThe analysis included 567 HIV-infected adolescents, with 300 (52.9%) aged between 13 to 15 years, 335 (59.1%) female, and mean age of 15.6 years (interquartile range [IQR] 13.5–17.8. VL non-suppression was 31.4% (178/567). Male sex (AOR = 1.78, 95% CI 1.06, 2.99; p < 0.01), age 16–19 years (AOR = 1.78, 95% CI 1.06, 2.99; p < 0.05), No formal education (AOR = 3.67, 95% CI 1.48–9.09; p < 0.01), primary education (AOR = 2.23, 95% CI 1.05–2.32; p < 0.01), ART duration of > 12 months to 5 years (AOR = 3.20, 95% CI 1.31–7.82; p < 0.05), ART duration > 5 years (AOR = 3.47, 95% CI 1.39– 8.66; p < 0.01), WHO Clinical Stage II (AOR = 0.48, 95% CI: 0.28, 0.82; p < 0.01), second-line ART regimen (AOR = 2.38, 95% CI 1.53–3.72; p < 0.001) and comorbidities (AOR = 3.28, 95% CI 1.20–9.00; p < 0.05) were significantly associated with viral non-suppression.ConclusionsVL non-suppression among adolescents was almost comparable to the national average. VL non-suppression was associated with being male, age 16–19 years, education level, duration on ART therapy, WHO Clinical Staging II, second-line ART regimen, and presence of comorbidities. Adolescent-friendly strategies to improve VL suppression e.g. peer involvement, VL focal persons to identify and actively follow-up non-suppressed adolescents, patient education on VL suppression and demand creation for ART are needed, especially for newly-initiated adolescents and adolescents on ART for protracted periods, to foster attainment of the UNAIDS 95–95–95 targets.
【 授权许可】
CC BY
【 预 览 】
Files | Size | Format | View |
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RO202203048225017ZK.pdf | 1087KB | download |