Document Type

Article

Department

Institute for Human Development

Abstract

Background: In sub-Saharan Africa, data on virologic outcomes of young people living with HIV (YLWH) enrolled on antiretroviral therapy (ART) remains scarce. In this study, we describe the prevalence of HIV virological non-suppression (VNS) and its associated factors among YLWH aged 18–24 years from the Kenyan coast.

Methods: Data were analyzed for 384 YLWH who participated in a larger cross-sectional study conducted between November 2018 and September 2019 in two counties at the Kenyan coast (Kilif and Mombasa). Descriptive statistics were used to summarize sample characteristics and logistic regression was used for statistical modeling of factors associated with VNS. In this study, VNS was defned as plasma viral load≥1000 copies/mL.

Results: Among these YLWH with a mean age of 20.7 years (SD=2.2); 55.5% females, the overall prevalence of VNS was 32.0% (95% Confdence interval (95% CI): 27.5, 36.9%). In the multivariable logistic regression analysis, being from a largely rural setting (adjusted Odds Ratio (aOR) 1.73, 95% CI 1.10, 2.71; p=0.02), underweight (aOR 1.87, 95% CI 1.16, 3.01; p=0.01) and low self-reported ART adherence (aOR 2.83, 95% CI 1.34, 6.00; p=0.01) were signifcantly associated with higher odds of VNS in YLWH.

Conclusions: In this study, high levels of VNS were observed among YLWH and this was signifcantly associated with rural residency, nutritional and ART adherence problems. ART adherence counselling and nutritional support and education should be intensifed in this setting targeting YLWH residing mostly in rural areas. Given the high frequency of VNS, there is need to closely monitor viral load and profle HIV drug resistance patterns in youths from the Kenyan coast with confrmed virologic failure. The latter will help understand whether drug resistance also contributes to poor viral suppression in addition to, or exclusive of suboptimal ART adherence

Publication

BMC Infectious Diseases

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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