Determinants of viral load non-suppression among adolescents in Mbale District, Eastern Rural Uganda

Abstract Background Adolescents 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...

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Autores principales:	Joel Maena, Aduragbemi Banke-Thomas, Nelson Mukiza, Cynthia Ndikuno Kuteesa, Ronald Makanga Kakumba, Hajira Kataike, Samuel Kizito, Juliet Allen Babirye, Rita Nakalega
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	HIV ART Viral Load Adolescents, ART, Non-suppression Uganda Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/861c994a57574a0ea21f1336ba989cec
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spelling	oai:doaj.org-article:861c994a57574a0ea21f1336ba989cec2021-12-05T12:05:52ZDeterminants of viral load non-suppression among adolescents in Mbale District, Eastern Rural Uganda10.1186/s12981-021-00408-11742-6405https://doaj.org/article/861c994a57574a0ea21f1336ba989cec2021-12-01T00:00:00Zhttps://doi.org/10.1186/s12981-021-00408-1https://doaj.org/toc/1742-6405Abstract Background Adolescents 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. Methods We 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. Results The 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. Conclusions VL 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.Joel MaenaAduragbemi Banke-ThomasNelson MukizaCynthia Ndikuno KuteesaRonald Makanga KakumbaHajira KataikeSamuel KizitoJuliet Allen BabiryeRita NakalegaBMCarticleHIVARTViral LoadAdolescents, ART, Non-suppressionUgandaImmunologic diseases. AllergyRC581-607ENAIDS Research and Therapy, Vol 18, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	HIV ART Viral Load Adolescents, ART, Non-suppression Uganda Immunologic diseases. Allergy RC581-607
spellingShingle	HIV ART Viral Load Adolescents, ART, Non-suppression Uganda Immunologic diseases. Allergy RC581-607 Joel Maena Aduragbemi Banke-Thomas Nelson Mukiza Cynthia Ndikuno Kuteesa Ronald Makanga Kakumba Hajira Kataike Samuel Kizito Juliet Allen Babirye Rita Nakalega Determinants of viral load non-suppression among adolescents in Mbale District, Eastern Rural Uganda
description	Abstract Background Adolescents 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. Methods We 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. Results The 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. Conclusions VL 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.
format	article
author	Joel Maena Aduragbemi Banke-Thomas Nelson Mukiza Cynthia Ndikuno Kuteesa Ronald Makanga Kakumba Hajira Kataike Samuel Kizito Juliet Allen Babirye Rita Nakalega
author_facet	Joel Maena Aduragbemi Banke-Thomas Nelson Mukiza Cynthia Ndikuno Kuteesa Ronald Makanga Kakumba Hajira Kataike Samuel Kizito Juliet Allen Babirye Rita Nakalega
author_sort	Joel Maena
title	Determinants of viral load non-suppression among adolescents in Mbale District, Eastern Rural Uganda
title_short	Determinants of viral load non-suppression among adolescents in Mbale District, Eastern Rural Uganda
title_full	Determinants of viral load non-suppression among adolescents in Mbale District, Eastern Rural Uganda
title_fullStr	Determinants of viral load non-suppression among adolescents in Mbale District, Eastern Rural Uganda
title_full_unstemmed	Determinants of viral load non-suppression among adolescents in Mbale District, Eastern Rural Uganda
title_sort	determinants of viral load non-suppression among adolescents in mbale district, eastern rural uganda
publisher	BMC
publishDate	2021
url	https://doaj.org/article/861c994a57574a0ea21f1336ba989cec
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Determinants of viral load non-suppression among adolescents in Mbale District, Eastern Rural Uganda

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