Abstract

FACTORS ASSOCIATED WITH POOR VIRAL SUPPRESSION AMONG CHILDREN AND ADOLESCENTS ACCESSING ANTIRETROVIRAL THERAPY IN SELECTED HEALTH FACILITIES IN LAGOS, NIGERIA

Nneka Egbonrelu*, Adeola Awolola, Teniola Lawanson, Olabanjo Ogunsola, Olawale Ogunyemi and Remi Olaitan

ABSTRACT

Background: Nigeria has the second largest HIV burden in Sub-Saharan Africa, with high burden amongst children and adolescents. The main objective of the study was to determine the factors associated with poor viral suppression in children and adolescents accessing antiretroviral therapy in secondary health facilities in Lagos State. Methods: A descriptive retrospective study of children and adolescents living with HIV accessing care and support in ART treatment facilities in Lagos between January 2013 and June 2020. The Binary logistic regression model was done to identify the determinants of viral non-suppression among children and adolescents age groups. Results: The study population consisted of 363 children (age 0-9 years) and 275 adolescents (age 10-19 years). About 256(70 %) of children were virally unsuppressed and 118(43 %) had non-suppressed viral load status among adolescents. Binary logistic regression showed that children with WHO stage IV of HIV disease at initiation had greater odds (OR=7.984, 95% CI=1.042-61.163) of having suppressed viral load and children who live with their non-biological caregiver had greater odds of having a suppressed viral load compared to the biological caregiver group (OR=2.0421, 95% CI=1.083-10.965). Among adolescents, binary logistic regression showed location of abode and drug pick-up pattern as independent predictors of poor viral suppression. Adolescent patients living in rural setting had greater odds of being virally unsuppressed compared to those living in urban settlement (OR=1.755, 95% CI=1.001-3.083). Conclusions: There is a need to strengthen HIV programmes in rural areas where children and adolescents living with HIV are more likely to be virally unsuppressed.

Keywords: Children, Adolescents, HIV, Viral Load, Suppression.