Viral suppression and adherence in adolescents living with HIV in rural Tanzania

Adolescents living with HIV (ALHIV) in sub-Saharan Africa are affected by poor treatment outcomes, likely a consequence of poor adherence. To assess viral suppression rates and evaluate factors associated with achieving viral suppression and maintaining treatment adherence among ALHIV in rural Tanzania. Cross-sectional analysis of data from the Kilombero and Ulanga Antiretroviral Cohort in Ifakara, Tanzania, including adolescents aged 10-19 years on antiretroviral treatment (ART) ≥6 months at the time point of their first viral load (VL) measurement after implementation of routine VL testing from August 2017 through December 2023. VL ≥1000 copies/ml was considered unsuppressed. We assessed agreement between adherence measures (self-report, pill box return, pill count and visual analogy scale) and viral suppression. Logistic regression was used to determine factors associated with viral suppression. Of 319 included adolescents, 159 (50%) were male, 143 (45%) aged 10-13 years, 213 (74%) had disclosed their HIV status, 72 (23%) lived ≥50 kilometers from the clinic, 161 (55%) had a WHO stage III/IV and 80 (33%) had CD4 cell counts