Assessment of factors associated with unsuppressed hiv viral LOAD AMONG people living with hiv.: A case of nyaruguru district, rwanda, from july 2016 to june 2017.

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.