DETERMINANTS OF VIROLOGICAL FAILURE IN HIV PATIENTS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) IN THE UPPER EAST REGION OF GHANA, 2022

Abstract

Background: The UNAIDS target for the 3rd 90% stipulated that; 90% of HIV patients on ART attained VS by end of 2020 (Ansah, et al., 2021; Marsh et al., 2019). The WHO recommended intensified adherence counseling to increase VS rate (WHO, 2015). This research determined VLF in HIV patients and recommended strategic interventions to achieve the new third 95% VS rate by 2025 (UNAIDS, 2016). The GHS identified the UER as a hotspot with increased HIV prevalence and VLF. In 2019, the UER recorded an increase in HIV from 2.8% in 2018 to 3.6% leading to high VF (GHS, 2019). The Theory of Planned behavior was adapted to provide effective behavior change interventions to improve adherence and undetectable VL (Abraham C., 2009). Methods: A retrospective cross- sectional study with Consecutive sampling technique was conducted on the 366 participants aged ≥15 years, on ART for ≥6 months with VL results in 2020 (Dissertation L. , 2012). A random sampling method (MS, 2016) was used to select the 8 HCs and 4 piloted sites. Patients’ folders and VL registers were reviewed. Kobo Collect tool (version v2021.2.4) with designed structured questionnaire (KoBo, 2017) was used to collect face-to-face data. Microsoft Excel (version 10) was used to clean the data and SPSS (version 26) used for data analysis. Logistic regression analysis was conducted with 95% C.I. and p-value ≤ 0.05 (Gunarto, 2019). Results: 73.2% of the respondents were female and 37.2% were within the age group 25-34. The prevalence of VLF was 47% and ART Adherence was 62.6%. The predictors of VF were non-formal education (OR=8.873, 95% C.I.=2.578 - 30.541), basic education (OR=7.283, 95% C.I. =2.020 - 26.259), SHS/Voc/Tech education (OR=5.111, 95% C.I.=1.400 - 18.654). 61% earned monthly income ˂GH¢375.00 (OR=8.134, 95% C.I.=1.697 - 38.995), alcohol intake (OR=0.425, 95% C.I.=0.197 - 0.915) and ART duration ˂1 year (OR=0.293, 95% C.I.=0.094 - 0.192). Other predictor factors were ART regimen (high Tenofovir+Lamivudine+Efavirenz) (OR=4.883, 95% C.I.=1.172 - 20.346), 2-4 times missed medication per month (OR=0.023, 95% C.I.=0.008 – 0.064) and ≥5 missed medication per month (OR=0.113, 95% C.I.=0.036 - 0.351). Conclusion: This study determined factors that were associated with VF in HIV patients in the UER and found that VF was about half percent.