Treatment factors associated with viral suppression among adolescents on antiretroviral therapy in Kenya

Background: There are approximately 99,159 adolescents living with human immunodeficiency virus in Kenya, with a viral suppression rate of 67%, according to the Joint United Nations Program on HIV/AIDS in 2021 [1] . There are limited studies in Kenya on factors associated with viral load suppression among adolescents. The objectives of this study were to determine the treatment factors associated with viral suppression among adolescents on antiretroviral therapy. Methods: A retrospective cross-sectional analysis of 38,503 HIV-infected adolescents receiving antiretroviral therapy for at least 6 months with a documented viral load result. The data was from routinely collected HIV program data in Kenya that is submitted from comprehensive care centers with electronic medical records to the National Aids and STI Control Program (NASCOP) for the period of January 2018–December 2022. Results: The study population was 38503 HIV-infected adolescents (10–19 years) on antiretroviral therapy. The viral suppression was at 81.2%., higher than the 2021 UNAIDS estimate of 67%. low detectable levels were 88%, low level viremia was 12%, high-risk LLV was 38%, and suspected treatment failure as 62%. Virological suppression with integrase strand transfer inhibitors based regimens – Abacavir and Tenofovir was 81.6% and 86.4%, respectively. The suppression with protease inhibitors based regimens was 70% (highest) and 56.4% (Lowest) Conclusion: The viral suppression among adolescents on antiretroviral therapy was 81.2% lower than the UNAIDS 95/95/95 global target but higher than the 2021 UNAIDS estimate of 67%. There is a need to interrogate the viral suppression in adolescents on protease inhibitors.