Factors associated with viral load non-suppression in people living with HIV on ART in Nigeria : cross-sectional analysis from 2017 to 2021

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dc.contributor.author Tomescu, Silviu
dc.contributor.author Crompton, Thomas
dc.contributor.author Adebayo, Jonathan
dc.contributor.author Akpan, Francis
dc.contributor.author Dauda, Dauda Sulaiman
dc.contributor.author Allen, Zola
dc.contributor.author Ondura, Evans Odhiambo
dc.contributor.author Kinge, Constance Wose
dc.contributor.author Chasela, Charles
dc.contributor.author Pisa, Pedro Terrence
dc.date.accessioned 2024-03-19T11:32:31Z
dc.date.available 2024-03-19T11:32:31Z
dc.date.issued 2023-05
dc.description DATA AVAILABILITY STATEMENT : Data are available on reasonable request. The data that support the findings of this study are owned by the Government of Nigeria and were used under license for the current study. Access to these data is subject to restrictions owing to privacy and ethics policies set by the Government of Nigeria so are not publicly available. en_US
dc.description.abstract OBJECTIVES : Identify factors (demographic and clinical) associated with a non-suppressed viral load (VL) of people living with HIV (PLHIV) on antiretroviral therapy (ART) in Nigeria. DESIGN : Cross-sectional study. SETTING : Sixteen US Agency for International Development supported states in Nigeria. PARTICIPANTS : 585 632 PLHIV on ART. PRIMARY OUTCOME MEASURES : VL non-suppression (defined as having a VL of at least 1000 HIV RNA copies per mL of plasma). χ2 testing and multivariable modified Poisson regression with robust variance estimates were conducted on routinely collected ART programme data. RESULTS : Sixty-six per cent of the study population were females. The largest age groups were 25–34 and 35–44, accounting for 32.1% and 31.1%, respectively. Males had a 9% greater likelihood (adjusted prevalence ratio, APR=1.09) of being non-suppressed. The age groups below 60+ (APR=0.67) had a higher likelihood of a non-suppressed VL, with the highest in the 0–14 age group (APR=2.38). Clients enrolled at tertiary and secondary level facilities had the greatest likelihood of a non-suppressed VL. Clients who started ART between 2010 and 2015 had the greatest likelihood of viral non-suppression (APR=6.19). A shorter time on ART (<1 year (APR=3.92)) was associated with a higher likelihood of a non-suppressed VL. Clients receiving care at private facilities had a lower likelihood of viral non-suppression in the adjusted model. Clients in the Edo (APR=2.66) and Niger (APR=2.54) states had the greatest likelihood of viral non-suppression. CONCLUSIONS : Targeting males, clients of younger age, those on treatment for less than 3 years, clients at tertiary and secondary health facilities, small and medium facilities, and clients in the Edo, Niger and Borno states for interventions could lead to improvements in VL suppression in Nigeria. The independent factors associated with a non-suppressed VL can guide improvements in ART programme development and VL suppression of PLHIV on ART in Nigeria. en_US
dc.description.department Human Nutrition en_US
dc.description.librarian am2024 en_US
dc.description.sdg SDG-03:Good heatlh and well-being en_US
dc.description.sponsorship Data for Implementation (Data.FI) is a cooperative agreement funded by the U.S. Agency for International Development. en_US
dc.description.uri http://bmjopen.bmj.com en_US
dc.identifier.citation Tomescu, S., Crompton, T., Adebayo, J., et al. Factors associated with viral load non-suppression in people living with HIV on ART in Nigeria: cross-sectional analysis from 2017 to 2021. BMJ Open 2023; 13: e065950. DOI:10.1136/bmjopen-2022-065950. en_US
dc.identifier.issn 2044-6055 (online)
dc.identifier.other 10.1136/ bmjopen-2022-065950
dc.identifier.uri http://hdl.handle.net/2263/95277
dc.language.iso en en_US
dc.publisher BMJ Publishing Group en_US
dc.rights © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. en_US
dc.subject Infectious diseases en_US
dc.subject Public health en_US
dc.subject Human immunodeficiency virus (HIV) en_US
dc.subject Acquired immune deficiency syndrome (AIDS) en_US
dc.subject People living with HIV (PLHIV) en_US
dc.subject Antiretroviral therapy (ART) en_US
dc.subject SDG-03: Good health and well-being en_US
dc.subject Nigeria en_US
dc.title Factors associated with viral load non-suppression in people living with HIV on ART in Nigeria : cross-sectional analysis from 2017 to 2021 en_US
dc.type Article en_US


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