Factors Affecting Viral Suppression Among HIV Positive Adults On Art At The 37 Military Hospital

Abstract

Background: HIV has affected more than 38 million globally with more than 25 million living in SSA. There have been interventions to address and end the HIV/AIDS epidemic by 2030, one of which is ART which facilitates viral suppression levels among PLWHAs. It is expected that, 95% of PLWHAs on ART achieve viral suppression by 2030 in order to achieve the goal of ending the AIDS epidemic. Ghana missed the viral suppression target in 2020 and intensified efforts are required to close the gap and achieve the goal by 2030. It is critical to identify factors affecting viral suppression and address bottlenecks to enhance changes of achieving sustained viral suppression in Ghana, which formed the main objective of this study. Methods: A cross-sectional study with retrospective quantitative analysis of ART and viral load data was conducted at the 37 Military Hospital in Ghana. A census of all HIV positive adults initiating treatment from April 1, 2018 to June 30, 2020 was used for the study. Additional data was collected with a structured questionnaire. Chi square test of independence was used to determine the association of independent variable with viral suppression. However, Fisher’s exact P-values were reported for variable with count items less than 5. The exact logistic regression analysis was further used to determine the main factors affecting viral suppression (significant at α=0.05) Results: A total of 257 patients participated in the study. The mean age of respondents was 40 years (±10.7). Sex distribution was 63% females and 37% males. The adherence rate based on the MMAs-8 was 75.5%. From the study, 61.1% of respondents had undetectable levels of viral load whereas 31.1% and 2.3% had viral load of 20-200copies/ml and 201-999copies/ml respectively. The overall rate of viral suppression was 94.6% among HIV positive adults on ART. The factors affecting viral suppression were adherence to ARTs (AOR = 4.83; 95% CI = 1.35, 17.2; p=0.015) and clinic attendance (AOR = 4.83; 95% CI = 1.35, 17.2; p=0.015). Conclusion: Viral suppression rate observed from the 37 Military Hospital was high among HIV positive adults on ART. It is important to strengthen activities that promote adherence to ARTs to sustain viral suppression levels among PLWHA accessing treatment at the hospital.