Effectiveness of HIV Prevention Strategies (Art, Pre-Exposure Prophylaxis and Awareness Campaigns) in Reducing HIV Incidence in Nigeria
1 Department of Medicine, Abia State University, Nigeria.
2 Department of Economic Development, University of Southern Mississippi, United States.
3 Department of Medicine, Abia State University, Nigeria.
4 Department of Public Administration, Nassarawa State University, Nigeria.
Research Article
Open Access Research Journal of Science and Technology, 2022, 06(02), 086-112.
Article DOI: 10.53022/oarjst.2022.6.2.0082
Publication history:
Received on 13 October 2022; revised on 24 December 2022; accepted on 28 December 2022
Abstract:
INTRODUCTION: Human immunodeficiency virus (HIV) infection can lead to acquired immunodeficiency syndrome (AIDS). AIDS is characterized by immunosuppression and is a public health concern. Viral load suppression represents an important cost-effective HIV prevention strategy to improve health outcomes and associated health care costs.
METHOD: This retrospective cross-sectional study was conducted among adults (18 years and older) in 2021 living with HIV/AIDS who received clinical care. The case files of adult HIV clients were reviewed and relevant data extracted using case report form journal.
RESULT: The prevalence of viral load suppression in this study was 90% (N=280). Participants were predominantly female (64.4%), aged 30-49 (62.1%), living in urban areas (60.7%), self-employed (39.3%), and retained in ART care for at most 14 years (80.4%), on first line HAART regimen (70.7%), in WHO clinical stage 1 (86.1%), and baseline CD4 count between 200 and 349 cells/μl (41.1%)
FINDINGS: After chi square statistical analysis, the following variables were found to be statistically significantly associated with viral load suppression: Gender (P= 0.038), ethnicity (P=0.016), duration on HAART regimen (P= 0.002), level of adherence (P= 0.00001), retention in care ((P= 0.000012) and WHO clinical stage (P=0.027) with level of adherence being the strongest determinant predicting viral load suppression among the study cohort (OR = 5; 95% CI=2.535-10.064)
CONCLUSION AND RECOMMENDATION: Viral suppression rates among ART users was below the WHO recommended target of 95% viral suppression in patients receiving ART. Among all risk factors for viral load suppression, the level of clinical appointment adherence was the highest predictor of suppressed viral load outcomes, however other factors such as duration on ART, type of ART regimen, Retention in care, and WHO clinical stage of the disease were also identified as determinants of VLS.
Keywords:
HIV; Viral load suppression; Antiretroviral therapy; Adherence; Nigeria.
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