Enhanced adherence counselling and viral load pattern amongst people living with HIV/AIDS in a Nigerian government hospital
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20260285Keywords:
Antiretroviral therapy, Enhanced adherence counselling, Viral load suppressionAbstract
Background: Antiretroviral therapy (ART) remains the primary treatment for Human immunodeficiency virus (HIV) infection, aiming to reduce viral replication and mortality, but this requires lifelong adherence. To achieve viral load suppression (VLS) (below 1,000 copies/ml), the World Health Organization (WHO) recommends annual VL measurements and enhanced adherence counselling (EAC). To determine the prevalence of VLS following EAC amongst the virally unsuppressed PLHIV at the Rivers State University Teaching Hospital (RSUTH) and factors influencing their virology outcomes.
Methods: A retrospective descriptive review of records of 330 virally unsuppressed PLHIV, aged 18 years and more, from September 2021–March 2023.
Sampling method: Random sampling method of those on comprehensive 3 sessions of monthly EAC. Ethical approval was obtained from the RSUTH ethical committee and an informed consent received from the ART management team. Data was collated and associations analysed with statistical significance set at p-value of<0.05.
Results: The prevalence of VLS after EAC3 (three sessions) was 70.9%. Highest preponderances were among females (51.5%), middle aged (73.3%), unemployed (71.1%), those on first line ART regimen (71.3%), CD4 count of <200 cells/mm3 and statistically significant levels (p-value<0.01) in those who had < five years ART (79.5%). There were also significant logistic regression scores (4.119, p=0.042 and 41.173, p=0.000, respectively) for VLS levels after EAC2 and EAC3.
Conclusions: Administration of at least three sessions of EAC with VL monitoring is helpful in achieving viral suppression in PLHWA.
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References
Huh JH, Kang DR, Kim JY, Koh KK. Metabolic syndrome fact sheet 2021: executive report. CardioMetabolic Syndr J. 2021;1(2):125-34. DOI: https://doi.org/10.51789/cmsj.2021.1.e15
Onwunata A, Ebong OO, Enoh G. Factors associated with non-adherence of HIV/AIDS patients to HAART regimen in a healthcare facility in Ikot Ekpene, Akwa Ibom State, Nigeria. J AIDS and HIV Res. 2019;11(3):16-24. DOI: https://doi.org/10.5897/JAHR2018.0481
Usman SA, Shehu A, Ajumobi O, Gidado S, Dalhatu I, Balogun M, et al. Predictors of non-adherence to antiretroviral therapy among HIV patients in secondary health care facilities in Kano State- Nigeria: a case-control study. Pan Afr Med J. 2019;32 (1):3.
World Health Organisation. WHO 2016 HIV guidelines. 2016. Available at: http://apps.who.int/iris/bitstream. Accessed on 21 September 2025.
Bvochora T, Satyanarayana S, Takarinda KC, Bara H, Chonzi P, Komtenza B, et al. Enhanced adherence counselling and viral load suppression in HIV seropositive patients with an initial high viral load in Harare, Zimbabwe: Operational issues. PLoS One. 2019;14(2):211326. DOI: https://doi.org/10.1371/journal.pone.0211326
Bonner K, Mezochow A, Roberts T, Ford N, Cohn J, Bonner K, et al. Viral Load Monitoring as a Tool to Reinforce Adherence: A Systematic Review. J Acquir Immune Defic Syndr Publ Lippincott Williams Wilkins J J Acquir Immune Defic Syndr. 2013;6464(1):74–874. DOI: https://doi.org/10.1097/QAI.0b013e31829f05ac
Atnafu GT, Moges NA, Wubie M, Gedif G. Incidence and predictors of viral load suppression after enhanced adherence counseling among HIV-positive adults in West Gojjam Zone, Amhara Region, Ethiopia. Infect Drug Resis. 2022;2:261-74. DOI: https://doi.org/10.2147/IDR.S341392
Awolude OA, Olaniyi O, Moradeyo M, Abiolu J. Virologic outcomes following enhanced adherence counselling among treatment experienced HIV positive patients at University College Hospital, Ibadan, Nigeria. Methodology. 2018;2:986.
Salami AO, Abiodun PO, Sanni OF, Salami HA. Effects of Enhance Adherence Counselling on Viral Load Suppression Among High Viral Load HIV Seropositive Patients in a Nigerian Tertiary Health Facility. Texila International J Acad Res. 2023;4:975.
Obasa GB, Ijaiya M, Okwor E, Dare B, Emerenini F, Oladigbolu R, et al. Factors associated with viral load re-suppression after enhanced adherence counseling among people living with HIV with an initial high viral load result in selected Nigerian states. PLOS Glob Public Health. 2024;4(11):2876. DOI: https://doi.org/10.1371/journal.pgph.0002876
Nakaye C, Mukiza N, Mawanda D, Kataike H, Kaganzi H, Ahimbisibwe GM, et al. Viral load suppression after intensive adherence counselling among adult people living with HIV at Kiswa health centre, Kampala: a retrospective cohort study. Secondary data analysis. AIDS Res Ther. 2023;20(1):18. DOI: https://doi.org/10.1186/s12981-023-00513-3
Izudi J, Castelnuovo B, King R, Cattamanchi A. Impact of intensive adherence counseling on viral load suppression and mortality among people living with HIV in Kampala, Uganda: a regression discontinuity design. PLOS Global Public Health. 2023;3(8):2240. DOI: https://doi.org/10.1371/journal.pgph.0002240
Akpan U, Nwanja E, Ukpong KA, Toyo O, Nwaokoro P, Sanwo O, et al. Reaching viral suppression among people with HIV with suspected treatment failure who received enhanced adherence counseling in Southern Nigeria: a retrospective analysis. Forum Infect Dis. 2022;9(12):651. DOI: https://doi.org/10.1093/ofid/ofac651
Ukwueze LN, Ifeanyi CIC, Iroegbu GA, Aribike J, Ikeneche NF. Evaluation of Enhanced Adherence Counselling among Virally Unsuppressed HIV‐Infected Adults on Antiretroviral Therapy in Suburban and Metropolitan Parts of Delta State, Nigeria. J Community Med Public Health. 2025;2(24):2577-28.
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