Factors Associated with Virological Non-suppression among HIV Positive Patients on Highly Active Antiretroviral Therapy in Public Hospitals, Addis Ababa, Ethiopia

Abstract

Abstract Background In Ethiopia approximately 1.3 million people live with HIV. Even though the number of people accessing antiretroviral therapy (ART) has gradually increased in the recent years the goal of attaining virologic suppression is not yet achieved. The objective of the study was to determine the factors associated with virologic non-suppression among HIV +ve patients on Highly Active Antiretroviral Therapy (HAART) in public hospitals, Addis Ababa, Ethiopia. Methods and Materials A 1:3 unmatched case control study was conducted starting from June 24, 2019 to July 19, 2019. 100 virologically non suppressed and 300 virologically suppressed HIV +ve patients were included and admitted and critically ill HIV +ve patients were excluded. Data was collected using questionnaires, entered using Epi-Info v 7.1 and analyzed using SPSS version 23. After ‘simple’ binary logistic regression, ‘multiple’ binary logistic regression analysis was carried out to identify the independent determinants of virological non suppression. We used p < 0.05. Result A total of 400 study participants (100 virologically non-suppressed and 300 virologically suppressed) participated in this study. The mean age of cases and controls was 37yrs and 43 yrs respectively. The mean duration on HAART of cases and controls was 106 months and 115 months respectively. Factors associated with virologic non suppression were age <35yrs (AOR=11.9, 95%CI 2.2-66.6), initial viral load > 1000 copies/ml (AOR=324.0, 95%CI 66.2 1585.9) and poor/fair adherence (AOR=9.2, 95%CI 3.2-26.7). Conclusion This study showed that age <35yrs, initial viral load > 1000copies/ml and poor/fair adherence is predictors of virological non suppression. Therefore, efforts should be strengthened to improve adherence to ART, which helps to suppress viral replication and load. Additionally, it is important to give more attention to younger (<35yrs) patients. Key words: HIV, Virologic non-suppression, case-control, Addis Ababa, Ethiopia