Factors Associated with HIV Viral Load suppression AmongAdults at HIV Care and Treatment Centers in Dodoma, Mtwaraand Lindi Region, July 2018-June 2019

O.I.N. Machangu
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Abstract

Despite the increase number of people living with HIV still there are limited information about the factors associated with viral load suppression among HIV+ individual enrolled into HIV care and treatment centers in Tanzania. Data reports that 87% of those who are living with HIV have attained viral suppression. However this is still low compare to the UNAIDS global targets that by 2020 of 90% on treatment must achieve viral suppression. Viral load remains a gold standard for assessing treatment outcome for those who are on treatment. In 2014 UNAIDS introduced 90- 90-90 goal so as to combat HIV epidemic by 2020. First 90% know there status, second 90 accessing treatment and Third 90% viral suppression. The aim of this study was therefore to identify factors affecting viral load suppression among HIV+ adults attending care and treatment services in the regions. Crossectional analytical study conducted at Dodoma, Mtwara and Lindi regions in randomly selected health facilities. 459 participants who are on ART for atleast 12 months and 18+ years were recruited for the study. Structured questionnaire was used. Data was entered, cleaned and analyzed using EPI info 7.2.2.16. Odds ratio was used to establish association, 95% CI, and P value of 0.05 were used for statistically significance. A total of 459 study participants were enrolled. The prevalence of viral load suppression was 79%. Viral load suppression was found to be association with Satisfaction to care OR, 11.6 (95% CI: 1.2, 113.6) and Stigma level OR, 2.5 (95% CI: 1.03, 6.1) and found to be statistically significant. Majority of participants were female 165 (68.6%), married 185 (40.3%), with primary education 309 (67.3%) and 280 (61%) had small business or self-employed. Those younger than 35 years had a 70% reduced chance of having viral load suppression OR 0.7 (95% CI: 0.41 OR 1.18), gender OR 0.85 (95% CI: 0.5,1.35), marital status OR, 0.93 ( 95% CI: 0.59, 1.47), those with primary education level OR, 0.47, (95% CI: 0.22 OR 0.99), duration on ART OR, 0.46 (95%:0.15,1.42) disclosure status OR, 0.39 (95% CI: 0.15, 1.01)there were found to be associated with viral suppression but not statistically significant. Satisfaction with care and low level of stigma were associated with viral load suppression.
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2018年7月至2019年6月,Dodoma、mtwarand和Lindi地区艾滋病毒护理和治疗中心成年人艾滋病毒载量抑制相关因素
尽管艾滋病毒感染者人数有所增加,但在坦桑尼亚艾滋病毒护理和治疗中心登记的艾滋病毒阳性个体中,有关抑制病毒载量的相关因素的信息仍然有限。数据显示,87%的艾滋病毒感染者实现了病毒抑制。然而,与联合国艾滋病规划署到2020年90%的治疗必须实现病毒抑制的全球目标相比,这一比例仍然很低。病毒载量仍然是评估那些正在接受治疗的人的治疗结果的金标准。2014年,联合国艾滋病规划署提出了“90-90 -90”目标,目标是到2020年防治艾滋病毒流行。前90%的人知道病情,后90%的人获得治疗,第三90%的人病毒受到抑制。因此,本研究的目的是确定在这些地区接受护理和治疗服务的HIV+成人中影响病毒载量抑制的因素。在多多马、姆特瓦拉和林迪地区随机选择的卫生设施中进行了横断面分析研究。这项研究招募了459名接受ART治疗至少12个月和18年以上的参与者。采用结构化问卷。使用EPI信息7.2.2.16录入、清理和分析数据。采用优势比确定相关性,95% CI, P值0.05表示差异有统计学意义。共有459名研究参与者被纳入研究。病毒载量抑制的患病率为79%。病毒载量抑制与护理满意度OR为11.6 (95% CI: 1.2, 113.6)和柱头水平OR为2.5 (95% CI: 1.03, 6.1)相关,且具有统计学意义。大多数参与者是女性165人(68.6%),已婚185人(40.3%),受过小学教育的309人(67.3%),有小生意或自雇的280人(61%)。年龄小于35岁的患者出现病毒载量抑制的几率降低70%,OR为0.7 (95% CI: 0.41或1.18),性别OR为0.85 (95% CI: 0.5,1.35),婚姻状况OR为0.93 (95% CI: 0.59, 1.47),初等教育水平OR为0.47 (95% CI: 0.22或0.99),抗逆转录病毒治疗持续时间OR为0.46 (95% CI: 0.15,1.42),披露状况OR为0.39 (95% CI: 0.15, 1.01),均与病毒抑制相关,但无统计学意义。对护理的满意度和低程度的病耻感与病毒载量抑制有关。
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