VIRAL LOAD SUPPRESSION AND ASSOCIATED FACTORS AMONG HIV-INFECTED PATIENTS ON SECOND-LINE ANTIRETROVIRAL THERAPY AT PUBLIC HEALTH FACILITIES OF WEST GUJI, GUJI AND BORENA ZONES, SOUTHERN ETHIOPIA: FACILITY BASED CROSS-SECTIONAL STUDY

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Abstract Background Ethiopia is one of the nation’s most severely impacted by HIV, with an estimated 700,000 people living with HIV/AIDS. Hence, many health facilities were providing second-line antiretroviral therapy, however little was known about viral load suppression among second-line users. This study aimed to assess the proportion of viral load suppression and associated factors among HIV-infected patients on second-line antiretroviral therapy at public health facilities of west Guji, Guji and Borena zones, Southern Ethiopia. Methods A facility-based cross-sectional study was conducted among 256 HIV-infected patients on second-line antiretroviral therapy from January 1, 2019, to December 30, 2022, by using census after obtaining ethical clearance from Bule Hora University ethical review committee. Data were extracted using a structured, pre-tested checklist, entered into the EPI data version 3.1.0, and exported to SPSS version 25 for analysis. The proportion of viral load suppression was determined. A binary logistic regression model was fitted to identify factors associated with viral load suppression. Statistical significance was declared at a 95% confidence interval (CI) with a P-value <0.05. Results This study revealed that the proportion of viral load suppression among HIV-infected patients on second-line antiretroviral therapy was 73.8% (95% CI, 68.0–79.1). Those who missed the second-line antiretroviral regimen [AOR = 0.315, 95% CI (0.162–0.612)], a baseline viral load count of <10,000 copies/mm3 [AOR = 2.291, 95% CI (1.216-4.316)], and a baseline body mass index of ≥18.5 kg/m2 [AOR = 2.438, 95% CI (1.098–5.414)] were significantly associated with viral load suppression. Conclusions The proportion of patients with viral load suppression fell below the WHO’s and national level. Viral load suppression was significantly influenced by missed second-line antiretroviral doses, a baseline viral load count of <10,000 copies/ml, and a baseline body mass index of ≥18.5 kg/m2. Hence interventions targeting counseling to patients that missed their antiretroviral therapy, keeping patient’s viral load to be less than 10,000 copies/ml through adequate adherence counseling among second-line antiretroviral therapy were recommended.

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