Title

Factors associated with viral load suppression among PLHIV in Tanzania; Results from Tanzania HIV Impact Survey (THIS) 2016-17: Implications to the ART programs

Presenter

George Mgomela

Authors

C. Makafu^1,2,3, J. James², E. Karugendo³, R. Mdodo⁴, E. Gummerson⁵, G. Mgomela⁴, A. Ramadhani⁶, J. Mushi⁶, S. Jonnalagadda⁷, K. Lavilla⁸, J. Zelothe¹, G. Somi⁶, E. Luaula³, C. Vesper⁹, B. Simpoli¹⁰, V. Mugisha¹¹, K. Jackson⁷, R. McCree⁸, O. Malewo⁸, W. Nega¹, J. Justman¹²

Institutions

¹ICAP, Dar es Salaam, Tanzania, United Republic of, ²Ministry of Health, National AIDS Control Program, Dar es Salaam, Tanzania, United Republic of, ³National Bureau of Statistics, Dar es Salaam, Tanzania, United Republic of, ⁴CDC, Tanzania, Dar es Salaam, Tanzania, United Republic of, ⁵ICAP, NY, New York, United States, ⁶NACP, Dar es Salaam, Tanzania, United Republic of, ⁷CDC, Georgia, United States, ⁸CDC, Dar es Salaam, Tanzania, United Republic of, ⁹ICAP, Pretoria, South Africa, ¹⁰NBS, Dar es Salaam, Tanzania, United Republic of, ¹¹ICAP, Kigali, Rwanda, ¹²ICAP, New York, United States

Background: WHO recommends early initiation of antiretroviral drugs (ARV) to provide better clinical outcomes among People Living with HIV (PLHIV) and prevent progression to AIDS. Viral Load Suppression (VLS) has recently been globally adopted as universal approach in monitoring the effectiveness of antiretroviral treatments (ART). We analyzed data from the 2016-17 Tanzania HIV Impact Survey (THIS) to establish the prevalence and describe the factors associated with VLS among PLHIV age 15+ years
Methods: The THIS was a cross-sectional, household survey using two-stage stratified cluster sampling. The sample was powered to obtain VLS estimates at 95% CI of +/- 10% based on the surveyed number of HIV+ individuals. HIV status awareness and ARV use were both self-reported. Blood samples tested using the national HIV Rapid Test (RT) algorithm consisting of SD Bioline HIV 1/2 (screening RT) and Uni-Gold^TM (confirmatory RT). Those testing positive on both RTs were confirmed using BioRad Geenius^TM HIV-1/HIV-2 Supplemental Assay. VLS was defined as <1,000 HIV RNA copies/mL and described using weighted percentages; odds ratios (ORs) were estimated to determine co-factors associated with viral suppression
Results: Of the 31,579 eligible persons of ages 15+ years interviewed and tested; 1,831 were HIV-positive. Among all PLHIV, 51.82% (95% CI: 48.74, 54.88) were virally suppressed; 41.14% among males (95% CI: 36.23, 46.5) and 57.15% among females (95% CI: 53.79, 60.45). Factors independently associated with VLS included; female gender, Index (respondent) awareness of their HIV+ status, urban residence, age, widowed marital status, disclosure of HIV+ status [i.e. Index (respondent) HIV+ status known to partner, Index (respondent) knows HIV+ status of partner], higher CD4 counts, and number of sexual partners in the past 12 months
Conclusions: VLS is an effect of interaction amid diverse dynamics, besides central ARV administration. Consequently, ART programs should consider strategizing for efficient interplay between the personal, clinical, social and demographic VLS influences