Predictors of Virological Failure after Adherence-Enhancement Counseling among First-Line Adults Living with HIV/AIDS in Kombolcha Town, Northeast Ethiopia

BACKGROUND: HIV virological failure is a common challenging problem, even after adherence-enhancement counseling. However, there have been few studies on the determinants of virological failure after adherence-enhancement counseling among adult patients on antiretroviral therapy in Ethiopia in general, and there is variation across clients and settings for unknown reasons. Therefore, this study aimed to identify predictors of virological failure after adherence-enhancement counseling among adults living with HIV/AIDS. METHODS: A case–control study was conducted in the town of Kombolcha from January 1, 2019 to March 30, 2019 using simple random sampling for 338 participants. Data were collected through face-to-face interviews for social and personal characteristics and document review for clinical profiles. Descriptive statistics were used for frequency, proportions, and summary measures. Binary logistic regression analysis was carried out to identify the predictors of virological failure after adherence-enhancement counseling among adults. For multivariate logistic regression,P<0.05 was considered statistically significant. AORs are presented with 95% CIs. RESULTS: The odds of virological failure after adherence-enhancement counseling were higher following poor antiretroviral medication adherence (AOR 7.3, 95% CI 2.57–20.79) and for patients who had had a first high viral load (≥10,000 copies/mL, (AOR 5, 95% CI 1.86–13.56) and a history of opportunistic infection (AOR 3.7, 95% CI 1.11–8.44) compared with their counterparts. CONCLUSION: Poor antiretroviral medication adherence during adherence-enhancement counseling session, first viral load ≥10,000 copies/mL, and recent history of opportunistic infection were predictors of virological failure. Therefore, efforts should be strengthened to improve adherence to antiretroviral medication, which helps to boost immunity and suppress viral replication.