Bernard Kikaire1, Michael Ssemanda2, Alex Asiimwe3, Miriam Nakanwagi2, Twaha Rwegyema2, Gloria Seruwagi4, Stephen Lawoko5, Evarlyne Asiimwe6, Cassette Wamundu6, Ambrose Musinguzi6, Eric Lugada2, Elizabeth Turesson2, Marni Laverentz2, Denis Bwayo2. 1. Makerere University College of Health Sciences, Kampala, Uganda. Electronic address: bkikaire@gmail.com. 2. University Research Co., LLC, Department of Defense HIV/AIDS Prevention Program (DHAPP), Kampala, Uganda. 3. University Research Co., LLC, Department of Defense HIV/AIDS Prevention Program (DHAPP), Kampala, Uganda; Directorate of HIV, Uganda Peoples Defense Force (UPDF), Kampala, Uganda. 4. Makerere University College of Health Sciences, Kampala, Uganda. 5. Gulu University, Gulu, Uganda. 6. Directorate of HIV, Uganda Peoples Defense Force (UPDF), Kampala, Uganda.
Abstract
BACKGROUND: Uniformed service personnel have an increased risk of poor viral load suppression (VLS). This study was performed to evaluate the outcomes of interventions to improve VLS in the 28 military health facilities in Uganda. METHODS: This operational research was conducted between October 2018 and September 2019, among people living with HIV (PLHIV) in the 28 health facilities managed by the military in Uganda. Patients with a viral load (VL) >1000 copies/ml received three sessions of intensive adherence counselling (IAC), 1 month apart, after which a repeat VL was done. The main outcome was the proportion with a suppressed VL following IAC. RESULTS: Of the 965 participants included in this analysis, 592 (61.4%) were male and 367 (38.3%) were female. Average age was 35.5 ± 13.7 years, and 87.8% had at least one IAC session. At least 48.2% had a suppressed repeat VL. IAC increased the odds of VLS by 82% (P = 0.004), with adjusted OR of 1.56 (P = 0.054). An initial VL >10 000 copies/ml, being on antiretroviral therapy for at least 2 years, being male, and being <18 years of age were associated with repeat VL non-suppression. CONCLUSIONS: IAC marginally improved VL suppression. There is a need to improve IAC in military health facilities.
BACKGROUND: Uniformed service personnel have an increased risk of poor viral load suppression (VLS). This study was performed to evaluate the outcomes of interventions to improve VLS in the 28 military health facilities in Uganda. METHODS: This operational research was conducted between October 2018 and September 2019, among people living with HIV (PLHIV) in the 28 health facilities managed by the military in Uganda. Patients with a viral load (VL) >1000 copies/ml received three sessions of intensive adherence counselling (IAC), 1 month apart, after which a repeat VL was done. The main outcome was the proportion with a suppressed VL following IAC. RESULTS: Of the 965 participants included in this analysis, 592 (61.4%) were male and 367 (38.3%) were female. Average age was 35.5 ± 13.7 years, and 87.8% had at least one IAC session. At least 48.2% had a suppressed repeat VL. IAC increased the odds of VLS by 82% (P = 0.004), with adjusted OR of 1.56 (P = 0.054). An initial VL >10 000 copies/ml, being on antiretroviral therapy for at least 2 years, being male, and being <18 years of age were associated with repeat VL non-suppression. CONCLUSIONS: IAC marginally improved VL suppression. There is a need to improve IAC in military health facilities.