Abstract:
Introduction
By the end of 2015, nearly 37 million people were living with HIV and 46.3% were on antiretroviral
therapy. From the 90-90-90 strategy, by 2020 at a global level, 90% of all people living with HIV
who will be on antiretroviral will suppress viral load. Viral load suppression protects the immune
system and prevents HIV transmission at a high level. Studies have shown that people living with
HIV have near normal life expectancy assuming they suppressed their viral load. Rwanda counts
3% of HIV prevalence and 9% of unsuppressed people. The aim of this study is to assess factors
associated with unsuppressed HIV viral load among people living with HIV in Nyaruguru district.
Methods
A cross-sectional study was carried out in Nyaruguru district and involving 637 participants. Data
were collected using questionnaire and medical files review. The analysis was done using STATA.
P values and odd ratio at 95% confidence interval and 5% of margin error will be used to identify
significant variables and factors associated with unsuppressed HIV viral load.
Results
More than half of the study participants were female (Female: 57.77% and Males: 42.23%). The
prevalence of unsuppressed HIV viral load in Nyaruguru district was found to be8.9%. Further,
88.7% declared being satisfied with the service that they receive. Male gender was associated with
unsuppressed HIV viral load [Adjusted Odds Ratio [aOR = 3.02, P = 0.020]; history of clinical
failure [aOR = 3.14, P =0.034], history of treatment interruption [aOR= 8.29, P = 0.002] and
perception toward the whole life treatment [aOR = 4.32, P = 0.049] were other three factors
associated with unsuppressed HIV viral load.
Conclusion
Efforts to reduce transmission rate by treating HIV to suppress viral load are in place. However,
among interviewed patients, 83.8% had a good treatment adherence. Some of identified factors that
are associated with unsuppressed HIV viral load include being a male person, the treatment
interruption, bad perception toward the whole life treatment, the clinical failure and the health
providers’ confidentiality. Therefore, putting more efforts on patients counseling on HIV will
improve their knowledge adherence then, suppression. Further, improve the adherence and quality
of service will help in having suppressed viral load.
Recommendation
The supervision from upper to lower level and IEC to people living with HIV are recommended to
improve adherence and suppression rate.
