Background: A majority of clients on first-line antiretroviral therapy with an initial high viral load will resuppress following an adherence intervention. Some sociodemographic and clinical characteristics were found to affect resuppression. Few reports on the outcome of the intervention and its associated factors in our country, with inconsistent results and some missed clinical factors of potential association, have compelled this study. The study aimed to assess the proportion of viral load suppression and associated factors among clients on antiretroviral therapy in public hospitals of Hawassa City Administration, Ethiopia.
Methods: An institution-based cross-sectional study with retrospective document review was conducted among 342 participants on antiretroviral therapy enrolled for counseling since its start in November 2016. Data were captured using a pretested and structured checklist from all client charts with complete data, entered into EpiData 3.1.0 and exported to SPSS 27 for analysis. The proportion of viral load suppression was determined. Bivariate and multivariate logistic regressions were performed to identify associated factors. Statistical significance was determined at a 95% CI and P<0.05.
Results: The proportion of viral load suppression was found to be 40.9% (35.7%-46.5%). Nevirapine-based antiretroviral treatment regimens (AOR 0.125, 95% CI 0.034-0.464), malnutrition (AOR 0.565, 95% CI 0.329-0.971), poor adherence (AOR 0.504, 95% CI 0.287-0.886), lower CD4 count (AOR 0.149, 95% CI 0.071, 0.314), and fewer counseling sessions (AOR 0.330, 95% CI 0.149-0.729) were significantly associated with viral load suppression.
Conclusion: The proportion of viral load suppression is lower than that recommended by the World Health Organization. Nevirapine-based regimens, poor nutritional status, poor adherence, lower CD4 count, and fewer counseling sessions risk a lower proportion of viral load suppression. This calls for the need to devise strategies to address these factors and to revisit program implementation.
Purpose: Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) remains a global public health challenge and epidemic disease in sub-Saharan African (SSA) countries. Retention in HIV care should be emphasized to reach", 95-95-95" the Joint United Nations Program on HIV/AIDS (UNAIDS) target by 2030. In Tanzania, in spite of existing strategies to ensure retention, loss to follow-up (LTFU) among HIV-infected men is still a common challenge. With limited studies focusing on men's population, little is known on their perspectives on factors contributing to LTFU. This study aimed to explore factors contributing to LTFU among men living with HIV/AIDS in the Kibaha district and to try to formulate strategies that work for men.
Methods: The qualitative study using a phenomenological approach was conducted among 16 men with experience in LTFU from three HIV care and treatment clinics located in the Kibaha district. Purposive sampling was used to select informants for semi-structured in-depth interviews from August to December, 2021. The collected data was analyzed thematically.
Results: The findings were grouped into three themes which highlightedthe contribution of individual factors, socio-economic factors and health system factors. These factors include anticipated HIV-related stigma, lack of disclosure of their HIV status to their partners, poor knowledge on HIV care, unbearable antiretroviral (ART) medication side effects, sharing of ART medications with their partners, perceived good health status, financial difficulties, work-related travels, demanding employment schedules, spiritual belief in faith healing, poor conduct among healthcare workers and loss of Care and Treatment Clinic (CTC) cards hindered their use of ART services at clinics.
Conclusion: The findings from this study revealed linked multi-level factors that influence LTFU from HIV care among HIV-infected men. In order to retain men in HIV care, tailored intervention approaches should be formulated.
Objective: This study aimed to assess perceived HIV stigma and associated factors among adult ART patients in Wolaita Zone, Southern Ethiopia.
Methods: A facility-based cross-sectional study was conducted among 638 participants selected using a multistage sampling technique from July 10 to September 2020. A 12-item short version of the HIV stigma scale was used to measure HIV-related stigma. Data were collected by the interview method using a pre-tested questionnaire. Binary and multivariable logistic regression analyses were performed to identify the factors associated with the outcome variable. The strength and direction of the association were measured using the adjusted odds ratio (AOR) with a 95% confidence interval (CI). Statistical significance was declared at P-value <0.05.
Results: In this study, 57.8% (95% CI = 54.1%-61.9%) of people under HIV care perceived high stigma and 450 (70.5%) disclosed their HIV status. Widowed marital status (AOR = 2.984; 95% CI = 1.728-5.155), primary education (AOR = 3.36; 95% CI = 2.072-5.42), undisclosed HIV status (AOR = 1.657; 95% CI = 1.121-2.451), poor social support (AOR: 2.05; 95% CI = 1.195-3.433), and being member of an HIV support group (AOR: 0.396; 95% CI = 0.249-0.630) were significantly associated with perceived stigma.
Conclusion: The perceived stigma is high among adult ART patients in the study setting. Widowed marital status, primary education, undisclosed HIV status, membership to the social support network NEP+ and poor social support were predictors of perceived HIV stigma. Thus, ART patients should be given more psychosocial support to minimize their perceived public HIV-related stigma.
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