Viral suppression among adolescents and young people on antiretroviral treatment in a rural setting in Kenya, 2022

Introduction: In Kenya, adolescents and young people (AYP) living with HIV and on antiretroviral therapy (ART) have a low-level viral load suppression of 52% against the globally recommended 95%. Viral suppression outcomes and their associated factors among AYP on ART in Kenya’s rural setting are not well described. We described viral suppression outcomes among AYP on ART in rural Gatanga Sub-County. Methods: We conducted a cross-sectional study among AYP aged 10–24 years active on ART as of April 2022. The outcome variable was viral suppression of <1,000 viral copies/ml of blood. Data were abstracted from the electronic medical record system, cleaned, coded, and analyzed. Means described continuous variables, while frequencies and proportions described categorical variables. Prevalence odds ratios (POR) and their corresponding confidence intervals (CI) were used to determine the association between independent variables and the outcome of interest (viral suppression). Results: We analyzed 195 records of AYP on ART. The mean age was 16.7±SD4.3 years. Overall, the virological suppression rate was 90%, while that of those aged 10–14 years was 88%, and that of those aged 20–24 years was 86%. Only 39% had viral load results within the previous year. Second-line ART regimens (POR:5.47, 95%CI:1.98–15.08) relative to first-line and Protease Inhibitors (PI) & Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) based regimens (POR:3.14,95% CI:1.08–9.06) relative to Dolutegravir (DTG) based ART regimens were associated with non-suppression. Conclusions: Viral load suppression among AYP on ART was suboptimal. Second-line ART and use of PI & NNRTI-based ART regimens were risk factors for viral non-suppression. Optimised ART regimens could improve viral load suppression.