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Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling—What Can We Learn About Its Factors?

BACKGROUND: Introduction and expansion of antiretroviral therapy (ART) have turned the tide of HIV pandemic, thus helping people living with HIV (PLHIV) achieve viral suppression. This success may need to be complemented by intensified adherence counseling (IAC) to improve adherence to treatment. Ho...

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Autores principales: Mundamshimu, James Samwel, Malale, Kija, Kidenya, Benson R, Gunda, Daniel W, Bwemelo, Logious, Mwashiuya, Mwakile, Omar, Salhida Shamnte, Mlowe, Neema, Kiyumbi, Magwa, Ngocho, James S, Balandya, Emmanuel, Sunguya, Bruno, Mshana, Stephen E, Mteta, Kien, Bartlett, John, Lyamuya, Eligius, Mmbaga, Blandina Theophil, Kalluvya, Samuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069435/
https://www.ncbi.nlm.nih.gov/pubmed/37020794
http://dx.doi.org/10.2147/IDR.S393456
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author Mundamshimu, James Samwel
Malale, Kija
Kidenya, Benson R
Gunda, Daniel W
Bwemelo, Logious
Mwashiuya, Mwakile
Omar, Salhida Shamnte
Mlowe, Neema
Kiyumbi, Magwa
Ngocho, James S
Balandya, Emmanuel
Sunguya, Bruno
Mshana, Stephen E
Mteta, Kien
Bartlett, John
Lyamuya, Eligius
Mmbaga, Blandina Theophil
Kalluvya, Samuel
author_facet Mundamshimu, James Samwel
Malale, Kija
Kidenya, Benson R
Gunda, Daniel W
Bwemelo, Logious
Mwashiuya, Mwakile
Omar, Salhida Shamnte
Mlowe, Neema
Kiyumbi, Magwa
Ngocho, James S
Balandya, Emmanuel
Sunguya, Bruno
Mshana, Stephen E
Mteta, Kien
Bartlett, John
Lyamuya, Eligius
Mmbaga, Blandina Theophil
Kalluvya, Samuel
author_sort Mundamshimu, James Samwel
collection PubMed
description BACKGROUND: Introduction and expansion of antiretroviral therapy (ART) have turned the tide of HIV pandemic, thus helping people living with HIV (PLHIV) achieve viral suppression. This success may need to be complemented by intensified adherence counseling (IAC) to improve adherence to treatment. However, some PLHIV still face higher than acceptable viral loads despite being on treatment. PURPOSE: We investigated the factors associated with the failure to suppress HIV viral load after three months of IAC sessions. PATIENTS AND METHODS: This cross-sectional study analyzed secondary data from PLHIV-attended care and treatment clinics in Mwanza between January 2018 and December 2019 who had unsuppressed VL after being on ART for at least six months. We identified PLHIV in first-line ART with viral load evaluation before receiving IAC and had viral load results done at 90 days after IAC. We conducted descriptive statistics to examine the magnitude of viral suppression. Wilcoxon signed-rank test used to compare the median viral load before and after IAC sessions, and logistic regressions predicted the factors associated with failure. RESULTS: This study included 212 subjects. After intervention, most participants 85.9% (182) had significantly improved adherence compared to baseline. More than half 75.5% (160) of the participants had viral suppression after the intervention. Participants aged 18–25 years (AOR = 5.6, 95% CI, 1.1–29.6), unstable client during ART initiation (AOR = 0.3, 95% CI, 0.13–0.62), and poor adherence to ART (AOR = 4, 95% CI, 1.3–12.3) remained the main predictors of virological failure after IAC intervention. CONCLUSION: Even though virological suppression is influenced by ART adherence, the findings in this study have shown co-existence of other factors to be addressed. Unstable during ART initiation is a new factor identified in this study.
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spelling pubmed-100694352023-04-04 Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling—What Can We Learn About Its Factors? Mundamshimu, James Samwel Malale, Kija Kidenya, Benson R Gunda, Daniel W Bwemelo, Logious Mwashiuya, Mwakile Omar, Salhida Shamnte Mlowe, Neema Kiyumbi, Magwa Ngocho, James S Balandya, Emmanuel Sunguya, Bruno Mshana, Stephen E Mteta, Kien Bartlett, John Lyamuya, Eligius Mmbaga, Blandina Theophil Kalluvya, Samuel Infect Drug Resist Original Research BACKGROUND: Introduction and expansion of antiretroviral therapy (ART) have turned the tide of HIV pandemic, thus helping people living with HIV (PLHIV) achieve viral suppression. This success may need to be complemented by intensified adherence counseling (IAC) to improve adherence to treatment. However, some PLHIV still face higher than acceptable viral loads despite being on treatment. PURPOSE: We investigated the factors associated with the failure to suppress HIV viral load after three months of IAC sessions. PATIENTS AND METHODS: This cross-sectional study analyzed secondary data from PLHIV-attended care and treatment clinics in Mwanza between January 2018 and December 2019 who had unsuppressed VL after being on ART for at least six months. We identified PLHIV in first-line ART with viral load evaluation before receiving IAC and had viral load results done at 90 days after IAC. We conducted descriptive statistics to examine the magnitude of viral suppression. Wilcoxon signed-rank test used to compare the median viral load before and after IAC sessions, and logistic regressions predicted the factors associated with failure. RESULTS: This study included 212 subjects. After intervention, most participants 85.9% (182) had significantly improved adherence compared to baseline. More than half 75.5% (160) of the participants had viral suppression after the intervention. Participants aged 18–25 years (AOR = 5.6, 95% CI, 1.1–29.6), unstable client during ART initiation (AOR = 0.3, 95% CI, 0.13–0.62), and poor adherence to ART (AOR = 4, 95% CI, 1.3–12.3) remained the main predictors of virological failure after IAC intervention. CONCLUSION: Even though virological suppression is influenced by ART adherence, the findings in this study have shown co-existence of other factors to be addressed. Unstable during ART initiation is a new factor identified in this study. Dove 2023-03-30 /pmc/articles/PMC10069435/ /pubmed/37020794 http://dx.doi.org/10.2147/IDR.S393456 Text en © 2023 Mundamshimu et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Mundamshimu, James Samwel
Malale, Kija
Kidenya, Benson R
Gunda, Daniel W
Bwemelo, Logious
Mwashiuya, Mwakile
Omar, Salhida Shamnte
Mlowe, Neema
Kiyumbi, Magwa
Ngocho, James S
Balandya, Emmanuel
Sunguya, Bruno
Mshana, Stephen E
Mteta, Kien
Bartlett, John
Lyamuya, Eligius
Mmbaga, Blandina Theophil
Kalluvya, Samuel
Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling—What Can We Learn About Its Factors?
title Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling—What Can We Learn About Its Factors?
title_full Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling—What Can We Learn About Its Factors?
title_fullStr Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling—What Can We Learn About Its Factors?
title_full_unstemmed Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling—What Can We Learn About Its Factors?
title_short Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling—What Can We Learn About Its Factors?
title_sort failure to attain hiv viral suppression after intensified adherence counselling—what can we learn about its factors?
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069435/
https://www.ncbi.nlm.nih.gov/pubmed/37020794
http://dx.doi.org/10.2147/IDR.S393456
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