Viral Load Suppression Among Adults with HIV on Antiretroviral Therapy: Outcomes from a Lusaka District Hospital, Zambia

Abstract

Background and Objective: HIV/AIDS remains a major public health issue, worldwide, ranking among the top 10 causes of death, particularly in low-income countries. The objective of this research was to determine factors that influence viral suppression in HIV-positive individuals aged 15 years and older who are receiving antiretroviral therapy (ART) from Chawama First-Level Hospital. Methods: A cross-sectional study design was used to investigate viral load suppression (VLS) factors in adults on ART. Data were analyzed using descriptive and inferential statistics, specifically, the Pearson Chi-square test to assess variable associations. Additionally, logistic regression was used to analyze the relationship between independent variables and the outcome variable. All statistical tests were set at a 95% confidence level (p < 0.05). Data were analyzed using STATA version 14.2, Stata Corp LP, College Station, TX. Results: Out of 10,758 participants, 10,396 (96.64%) achieved viral suppression. Factors associated with viral suppression included the 35–39 age group (AOR = 1.56, p = 0.042) and the 50-and-above age group (AOR = 2.148, p = 0.006). Those not on tenofovir, lamivudine, and dolutegravir (TLD) or tenofovir alafenamide, emtricitabine, and dolutegravir (TAFED) regimens had lower odds (AOR = 0.14, p = 0.001). Longer treatment duration also showed a positive correlation with better odds: 1 year (AOR: 5.387), 2 years (AOR: 8.18), 3 years (AOR: 8.48), 4 years (AOR: 8.37), and 5 years (AOR: 12.13), all with p < 0.001. Additionally, multi-month dispensation (MMD) further demonstrated higher odds, particularly 3–5 months (AOR = 18.257) and 6+ months (AOR = 22.137), both p < 0.001. Conclusion and Implications for Translation: The research findings suggest that different socio-demographic and clinical factors may influence viral suppression. Therefore, the study recommends that People Living with HIV (PLWHIV) adhere to ART which should be encouraged by the health workers and strengthen MMD to increase the likelihood of VLS among PLWHIV.