Predictors and Facilitators of High Viral Load in HIV Positive Persons on Antiretroviral Treatment in the East Region of Cameroon

Abstract

Viral load (VL) determination is the standard to assess the effectiveness of Anti-retroviral Therapy (ART) in people living with HIV (PLWIV). According to Cameroon national ART guidelines, VL determination in PLHIV should be done after six months of starting ART and then every 12 months. Unsuppressed VL occurs when ARV’s fails to suppress viral load and is associated with decreased survival and increased risk of HIV transmission, morbidity, and mortality. A sequential and exploratory facility and community-based cross-sectional study was conducted on 391 patients on first-line ART in public health facilities in the East region of Cameroon from January 2021 to January 2022. Structural questionnaires and a review of medical records were the data source of the study. SPSS version 26 was used for data analysis, and Chi-squared (χ2) tests to explore the associations between outcome variables and the independent variables. Logistic regression analysis was performed to identify predictors and facilitators of high viral load at 95% CI and P < 0.05 statistically significant level. Age, marital status, Occupation, food insecurity, switching regimen, and non-adherence were found to be the predictors of high viral load, while the distance from the clinic, medication side effects, substance use, poverty, missing clinical appointment or ARV doses, knowledge on ARV and health personnel attitudes were found to be facilitators. Unsuppressed viral load among PLWH in the East region of Cameroon is cause by predictors and facilitators. Therefore, need for targeted interventions for patients on ART who are at high risk of becoming virally unsuppressed. Keywords. Adherence, Anti-retroviral therapy, Enhanced adherence counselling (EAC), Suppressed, Unsuppressed, Viral load.

Viral Load Suppression Among HIV Infected Adults On Antiretroviral Treatment In Rural Settings Of The Centre Region Of Cameroon: A Retrospective Cohort Study

“…Occupation at initiation was a significant predictor of viral load suppression, with farmers exhibiting statistically significant lower odds of unsuppressed viral load compared to the unemployed. This result aligns with a study conducted in Cameroon [20] and in a similar African setting [22], highlighting the impact of occupation on treatment outcomes. The unique challenges faced by different occupational groups, such as workrelated stressors or scheduling conflicts, may contribute to these disparities.…”

“…Concerning the behavioral and clinical factors influencing viral suppression, we found that individuals whose partners were informed of their HIV status had statistically significant lower odds of unsuppressed viral load compared to those who did not disclose, suggesting a consistent pattern across diverse settings [21]. The results of our study align with findings from Cameroon [20] and United Kingdom [22], emphasizing the crucial role of partner disclosure in achieving viral load suppression. This underscores the need for tailored interventions that promote open communication within relationships to enhance treatment outcomes.…”

“…While married individuals (monogamous) showed non-significant lower odds of unsuppressed viral load, those categorized as widowed, divorced, or in a concubine relationship exhibited non-significant trends towards higher odds of unsuppressed viral loads. A study in Cameroon found similar trends [20], highlighting the need for tailored support mechanisms for individuals with diverse marital statuses. Moreover, our study did not find a significant association between education level and viral load suppression, aligning with global evidence that emphasizes the need for comprehensive adherence support irrespective of educational background [20,21].…”

“…A study in Cameroon found similar trends [20], highlighting the need for tailored support mechanisms for individuals with diverse marital statuses. Moreover, our study did not find a significant association between education level and viral load suppression, aligning with global evidence that emphasizes the need for comprehensive adherence support irrespective of educational background [20,21].…”