Predictors of virological outcomes in patients with HIV on antiretroviral therapy in Osogbo, Nigeria: a cross-sectional study.

BACKGROUND

Virological outcome is a critical determinant of care in HIV management, as highlighted in the third portion of the UNAIDS 95-95-95 fast-track targets, emphasizing viral load suppression as an essential strategy for epidemiological control of HIV by 2030. There have been various reports regarding Nigeria's recent position, particularly concerning viral load suppression. This study aimed to determine the virological outcomes and associated predictors among HIV-infected individuals on highly active antiretroviral therapy (HAART) in three treatment facilities in Osogbo, Southwest Nigeria.

METHODOLOGY

This descriptive cross-sectional study involved 830 HIV-infected participants recruited from three treatment facilities in Osogbo, Nigeria, over eight months. The participants completed a proforma documenting their sociodemographic and clinical details as well as their responses to questions about HIV care (independent variables). Blood samples were collected for HIV viral load assays, with results defined as good (< 1000 copies/ml) or poor (≥ 1000 copies/ml) virological outcomes. The data obtained were analyzed using the Statistical Package for Social Sciences (SPSS) version 23. Associations between dependent (good and poor virological outcomes) and independent variables were assessed using bivariate analysis (Pearson's chi-square test). Multivariate analysis (binomial regression) was employed to determine predictors of virological outcomes. Statistical significance was set at a P value < 0.05, and confidence intervals were calculated at 95%.

RESULTS

The prevalence rates of poor and good virological outcomes were 15.54% and 84.46%, respectively. Predictors of virological outcomes included residential status, socioeconomic status (middle), adherence to HAART, knowledge of HIV medications and their side effects, comorbidity status, depression, pill quantity, disclosure status, family support, stigma, and discrimination (p < 0.05).

CONCLUSION

Although the good virological outcome (suppression) prevalence still fell short of the advocated 95%, improving adherence counseling, increasing financial empowerment to ease transportation costs to clinics, and eliminating stigmatization and discrimination in care are needed to enhance and sustain the HIV response.