Prevalence and Determinants of Undetectable Viremia among Recipients of Care Receiving HIV/AIDS Care in Akwa Ibom State, Nigeria

Background: Globally the benefits of undetectable viremia in preventing the transmission of HIV/AIDS have been established.

Objective: The study aimed to assess the prevalence and determinants of undetectable viral load amongst HIV/AIDS clients receiving care and treatment in RISE-supported facilities in Akwa Ibom State, Nigeria.

Methods: A descriptive cross-sectional study was conducted using secondary data from a validated Retention and Audit Determination Tool (RADET) file generated in September 2021. This was cleaned, imported into, and analyzed using a statistical package for social sciences (IBM SPSS) statistical package version 25. The prevalence of undetectable viremia was determined using descriptive statistics, and factors associated with undetectable viremia were assessed using chi-square analysis. Binary logistic regression was used to identify the determinants of undetectable viremia at an alpha level of <0.05 at a 95% confidence interval.

Results: out of 47,575 recipients on care, 85.7% had undetectable viremia. Residing in rural areas (p<0.001, OR=1.3), respondents aged 25-49 years (p=0.008, OR=1.32), and those placed on Multi-Month Dispensing (MMD 6) (p<0.001, OR=1.45) were more likely to have undetectable viremia. While students (p=0.035, OR=1.2), and those employed (p=0.001, OR=1.102) were less likely to have undetectable viremia.

Conclusion: This study reported a high prevalence of undetectable viremia. The determinants were occupation, residing in rural areas, productive age group, and being on MMD 6. Multiple interventions that include phone reminders and behavioral models to support self-care amongst urban dwellers are imperative. Differentiated interventions that include operation Triple Zero (OTZ) and Community Adolescent Treatment Supports (CATs) targeting the pediatric age group are needed to support the adherence to ART and undetectable viremia.