Factors Associated With Viral Load Nonsuppression Among Children and Adolscents Living With HIV Enrolled to the Orphans and Vulnerable Children Program at the Mildmay Center of Excellence in Wakiso District
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Date
2024-04-17
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Abstract
Introduction
This study was to determine the prevalence and factors associated with viral load non-suppression among children and adolescents orphan and vulnerable children program at MildMay center of Excellence. The study specifically sought to determine the prevalence of viral load non-suppression among children and adolescent enrolled on to the OVC program at Mild May center of Excellence in Wakiso, to explore the individual factors associated with VL non-suppression among children and adolescents enrolled on to the OVC program at Mild May center of Excellence in Wakiso and to determine the treatment-related factors associated with VL non-suppression among children and adolescents enrolled on to the OVC program at Mild May center of Excellence in Wakiso.
Method
This was across-sectional study design that employed both qualitative and quantitative methods. A total of 219 children and adolescent were enrolled in the study. Data was collected using a questionnaire and key informant interview guide. The data was then analyzed at univariate, bivariate and multivariate level using SPSS version 20.
Results
Majority 83(37.9%) of the respondents were aged 10-14 years. With the mean age being 9yrs. At bivariate level of analysis age (X2=12.671, df =3, P-value=0.001), sex (X2=17.04, df =1, P-value=0.000), residence (X2=9.87, df =1, P-value=0.002), educational level (X2=11.31, df =3, P-value=0.001), duration on ART, (X2=8.17, df =2, P-value=0.001) and starting regimen (X2=14.67, df =1, P-value=0.000), adherence (X2=19.56, df =3, P-value=0.000) and disclosure status (X2=11.60, df =1, P-value=0.001) were significantly associated with viral non suppression among children and adolescents enrolled on to the OVC program P-value <0.05.
At multivariate level, sex (AOR=2; 95% CI: 1.321- 2.048; p= 0.000), starting regimen (AOR=5; 95% CI: 1.895- 2.833; p= 0.003), adherence (AOR=6; 95% CI: 1.620- 1.901; p= 0.000) and disclosure (AOR=0.6; 95% CI: 1.461- 1.986; p= 0.002) were independently associated with viral non-suppression among children and adolescent enrolled on to the OVC program at Mild May center of Excellence in Wakiso
Conclusion
The study found out that the prevalence of non-suppression among children and adolescent enrolled on to the OVC program at Mild May center in Wakiso stood at 17.4%. this prevalence is higher than the UNAIDs 10%, and therefore directly affects the 3rd 95 in the UNAIDS 95,95, 95 targets. It can also be concluded that there are individual and treatment related factors that are associated with viral non-suppression among children and adolescent enrolled on to the OVC program as shown in the results above
Recommendations
Practitioners therefore should targeted mass campaign and sensitization to both care givers and clients on the effects of having a high viral load, there should be a deliberate effort by health workers at Mild May to address barriers to good adherence with ultimate aim of improving on the virological outcome, deliberate efforts on supported disclosure to children and adolescents twelve years and above and Continuous medical education and skilling of health care workers by the program on ART optimization for children and adolescents. Policy makers at ministry of health to enforce proper management of non-suppressors with emphasis on the male child and strengthen strategies on monitoring of non suppressed children and adolescents at all levels