HIV virological non-suppression is highly prevalent among 18- to 24-year-old youths on antiretroviral therapy at the Kenyan coast

Moses K. Nyongesa; Mwaganyuma H. Mwatasa; Vincent A. Kagonya; Gabriel Mwambingu; Caroline Ngetsa; Charles R.J.C. Newton; Amina Abubakar

doi:10.1186/s12879-022-07428-w

HIV virological non-suppression is highly prevalent among 18- to 24-year-old youths on antiretroviral therapy at the Kenyan coast

Moses K. Nyongesa^*
, Mwaganyuma H. Mwatasa
, Vincent A. Kagonya
, Gabriel Mwambingu
, Caroline Ngetsa
, Charles R.J.C. Newton
, Amina Abubakar

^*Corresponding author for this work

Clinical Psychology

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: In sub-Saharan Africa, data on virologic outcomes of young people living with HIV (YLWH) enrolled on antiretroviral therapy (ART) remains scarce. In this study, we describe the prevalence of HIV virological non-suppression (VNS) and its associated factors among YLWH aged 18–24 years from the Kenyan coast. Methods: Data were analyzed for 384 YLWH who participated in a larger cross-sectional study conducted between November 2018 and September 2019 in two counties at the Kenyan coast (Kilifi and Mombasa). Descriptive statistics were used to summarize sample characteristics and logistic regression was used for statistical modeling of factors associated with VNS. In this study, VNS was defined as plasma viral load ≥ 1000 copies/mL. Results: Among these YLWH with a mean age of 20.7 years (SD = 2.2); 55.5% females, the overall prevalence of VNS was 32.0% (95% Confidence interval (95% CI): 27.5, 36.9%). In the multivariable logistic regression analysis, being from a largely rural setting (adjusted Odds Ratio (aOR) 1.73, 95% CI 1.10, 2.71; p = 0.02), underweight (aOR 1.87, 95% CI 1.16, 3.01; p = 0.01) and low self-reported ART adherence (aOR 2.83, 95% CI 1.34, 6.00; p = 0.01) were significantly associated with higher odds of VNS in YLWH. Conclusions: In this study, high levels of VNS were observed among YLWH and this was significantly associated with rural residency, nutritional and ART adherence problems. ART adherence counselling and nutritional support and education should be intensified in this setting targeting YLWH residing mostly in rural areas. Given the high frequency of VNS, there is need to closely monitor viral load and profile HIV drug resistance patterns in youths from the Kenyan coast with confirmed virologic failure. The latter will help understand whether drug resistance also contributes to poor viral suppression in addition to, or exclusive of suboptimal ART adherence.

Original language	English
Article number	449
Pages (from-to)	1-10
Number of pages	10
Journal	BMC Infectious Diseases
Volume	22
Early online date	11 May 2022
DOIs	https://doi.org/10.1186/s12879-022-07428-w
Publication status	Published - 2022

Bibliographical note

Funding Information:
This work was funded by the Wellcome Trust International Master’s Fellowship to MKN (Grant Number 201310/Z/16/Z). Further funding supporting this work was from the Medical Research Council (Grant number MR/M025454/1) to AA. This award is jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under MRC/DFID concordant agreement and is also part of the EDCTP2 program supported by the European Union. The funders did not have a role in the design and conduct of the study or the interpretation of study findings. The views expressed in this publication are those of the author(s) and not necessarily those of Wellcome Trust, MRC or the UK government.

Funding Information:
We thank the young people for their voluntary participation in this study. We appreciate the overwhelming support from staff at the HIV clinics during the recruitment period. Special thanks go out to all our field team members at the NeuroAsessment unit and the team at KWTRP’s Clinical Trials Laboratory for professional handling and processing of blood samples. The authors would also like to acknowledge the permission from the Director, Kenya Medical Research Institute (KEMRI) to publish this work.

Publisher Copyright:
© 2022, The Author(s).

Funding

This work was funded by the Wellcome Trust International Master’s Fellowship to MKN (Grant Number 201310/Z/16/Z). Further funding supporting this work was from the Medical Research Council (Grant number MR/M025454/1) to AA. This award is jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under MRC/DFID concordant agreement and is also part of the EDCTP2 program supported by the European Union. The funders did not have a role in the design and conduct of the study or the interpretation of study findings. The views expressed in this publication are those of the author(s) and not necessarily those of Wellcome Trust, MRC or the UK government. We thank the young people for their voluntary participation in this study. We appreciate the overwhelming support from staff at the HIV clinics during the recruitment period. Special thanks go out to all our field team members at the NeuroAsessment unit and the team at KWTRP’s Clinical Trials Laboratory for professional handling and processing of blood samples. The authors would also like to acknowledge the permission from the Director, Kenya Medical Research Institute (KEMRI) to publish this work.

Funders	Funder number
European Commission
Department for International Development, UK Government
Kenya Medical Research Institute
UK Research and Innovation
Wellcome Trust	201310, 201310/Z/16/Z
Medical Research Council	MR/M025454/1

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 5 Gender Equality

Keywords

Antiretroviral therapy
HIV infections
Kenya
Prevalence
Risk indicators
Virological non-suppression
Young people
Youths living with HIV

Access to Document

10.1186/s12879-022-07428-w

Persistent URL (handle)

Persistent link

Cite this

@article{d8fca170dc7e43d2a53b31b734c9054e,

title = "HIV virological non-suppression is highly prevalent among 18- to 24-year-old youths on antiretroviral therapy at the Kenyan coast",

abstract = "Background: In sub-Saharan Africa, data on virologic outcomes of young people living with HIV (YLWH) enrolled on antiretroviral therapy (ART) remains scarce. In this study, we describe the prevalence of HIV virological non-suppression (VNS) and its associated factors among YLWH aged 18–24 years from the Kenyan coast. Methods: Data were analyzed for 384 YLWH who participated in a larger cross-sectional study conducted between November 2018 and September 2019 in two counties at the Kenyan coast (Kilifi and Mombasa). Descriptive statistics were used to summarize sample characteristics and logistic regression was used for statistical modeling of factors associated with VNS. In this study, VNS was defined as plasma viral load ≥ 1000 copies/mL. Results: Among these YLWH with a mean age of 20.7 years (SD = 2.2); 55.5\% females, the overall prevalence of VNS was 32.0\% (95\% Confidence interval (95\% CI): 27.5, 36.9\%). In the multivariable logistic regression analysis, being from a largely rural setting (adjusted Odds Ratio (aOR) 1.73, 95\% CI 1.10, 2.71; p = 0.02), underweight (aOR 1.87, 95\% CI 1.16, 3.01; p = 0.01) and low self-reported ART adherence (aOR 2.83, 95\% CI 1.34, 6.00; p = 0.01) were significantly associated with higher odds of VNS in YLWH. Conclusions: In this study, high levels of VNS were observed among YLWH and this was significantly associated with rural residency, nutritional and ART adherence problems. ART adherence counselling and nutritional support and education should be intensified in this setting targeting YLWH residing mostly in rural areas. Given the high frequency of VNS, there is need to closely monitor viral load and profile HIV drug resistance patterns in youths from the Kenyan coast with confirmed virologic failure. The latter will help understand whether drug resistance also contributes to poor viral suppression in addition to, or exclusive of suboptimal ART adherence.",

keywords = "Antiretroviral therapy, HIV infections, Kenya, Prevalence, Risk indicators, Virological non-suppression, Young people, Youths living with HIV",

author = "Nyongesa, \{Moses K.\} and Mwatasa, \{Mwaganyuma H.\} and Kagonya, \{Vincent A.\} and Gabriel Mwambingu and Caroline Ngetsa and Newton, \{Charles R.J.C.\} and Amina Abubakar",

note = "Funding Information: This work was funded by the Wellcome Trust International Master{\textquoteright}s Fellowship to MKN (Grant Number 201310/Z/16/Z). Further funding supporting this work was from the Medical Research Council (Grant number MR/M025454/1) to AA. This award is jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under MRC/DFID concordant agreement and is also part of the EDCTP2 program supported by the European Union. The funders did not have a role in the design and conduct of the study or the interpretation of study findings. The views expressed in this publication are those of the author(s) and not necessarily those of Wellcome Trust, MRC or the UK government. Funding Information: We thank the young people for their voluntary participation in this study. We appreciate the overwhelming support from staff at the HIV clinics during the recruitment period. Special thanks go out to all our field team members at the NeuroAsessment unit and the team at KWTRP{\textquoteright}s Clinical Trials Laboratory for professional handling and processing of blood samples. The authors would also like to acknowledge the permission from the Director, Kenya Medical Research Institute (KEMRI) to publish this work. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

doi = "10.1186/s12879-022-07428-w",

language = "English",

volume = "22",

pages = "1--10",

journal = "BMC Infectious Diseases",

issn = "1471-2334",

publisher = "BioMed Central Ltd",

}

TY - JOUR

T1 - HIV virological non-suppression is highly prevalent among 18- to 24-year-old youths on antiretroviral therapy at the Kenyan coast

AU - Nyongesa, Moses K.

AU - Mwatasa, Mwaganyuma H.

AU - Kagonya, Vincent A.

AU - Mwambingu, Gabriel

AU - Ngetsa, Caroline

AU - Newton, Charles R.J.C.

AU - Abubakar, Amina

N1 - Funding Information: This work was funded by the Wellcome Trust International Master’s Fellowship to MKN (Grant Number 201310/Z/16/Z). Further funding supporting this work was from the Medical Research Council (Grant number MR/M025454/1) to AA. This award is jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under MRC/DFID concordant agreement and is also part of the EDCTP2 program supported by the European Union. The funders did not have a role in the design and conduct of the study or the interpretation of study findings. The views expressed in this publication are those of the author(s) and not necessarily those of Wellcome Trust, MRC or the UK government. Funding Information: We thank the young people for their voluntary participation in this study. We appreciate the overwhelming support from staff at the HIV clinics during the recruitment period. Special thanks go out to all our field team members at the NeuroAsessment unit and the team at KWTRP’s Clinical Trials Laboratory for professional handling and processing of blood samples. The authors would also like to acknowledge the permission from the Director, Kenya Medical Research Institute (KEMRI) to publish this work. Publisher Copyright: © 2022, The Author(s).

PY - 2022

Y1 - 2022

N2 - Background: In sub-Saharan Africa, data on virologic outcomes of young people living with HIV (YLWH) enrolled on antiretroviral therapy (ART) remains scarce. In this study, we describe the prevalence of HIV virological non-suppression (VNS) and its associated factors among YLWH aged 18–24 years from the Kenyan coast. Methods: Data were analyzed for 384 YLWH who participated in a larger cross-sectional study conducted between November 2018 and September 2019 in two counties at the Kenyan coast (Kilifi and Mombasa). Descriptive statistics were used to summarize sample characteristics and logistic regression was used for statistical modeling of factors associated with VNS. In this study, VNS was defined as plasma viral load ≥ 1000 copies/mL. Results: Among these YLWH with a mean age of 20.7 years (SD = 2.2); 55.5% females, the overall prevalence of VNS was 32.0% (95% Confidence interval (95% CI): 27.5, 36.9%). In the multivariable logistic regression analysis, being from a largely rural setting (adjusted Odds Ratio (aOR) 1.73, 95% CI 1.10, 2.71; p = 0.02), underweight (aOR 1.87, 95% CI 1.16, 3.01; p = 0.01) and low self-reported ART adherence (aOR 2.83, 95% CI 1.34, 6.00; p = 0.01) were significantly associated with higher odds of VNS in YLWH. Conclusions: In this study, high levels of VNS were observed among YLWH and this was significantly associated with rural residency, nutritional and ART adherence problems. ART adherence counselling and nutritional support and education should be intensified in this setting targeting YLWH residing mostly in rural areas. Given the high frequency of VNS, there is need to closely monitor viral load and profile HIV drug resistance patterns in youths from the Kenyan coast with confirmed virologic failure. The latter will help understand whether drug resistance also contributes to poor viral suppression in addition to, or exclusive of suboptimal ART adherence.

AB - Background: In sub-Saharan Africa, data on virologic outcomes of young people living with HIV (YLWH) enrolled on antiretroviral therapy (ART) remains scarce. In this study, we describe the prevalence of HIV virological non-suppression (VNS) and its associated factors among YLWH aged 18–24 years from the Kenyan coast. Methods: Data were analyzed for 384 YLWH who participated in a larger cross-sectional study conducted between November 2018 and September 2019 in two counties at the Kenyan coast (Kilifi and Mombasa). Descriptive statistics were used to summarize sample characteristics and logistic regression was used for statistical modeling of factors associated with VNS. In this study, VNS was defined as plasma viral load ≥ 1000 copies/mL. Results: Among these YLWH with a mean age of 20.7 years (SD = 2.2); 55.5% females, the overall prevalence of VNS was 32.0% (95% Confidence interval (95% CI): 27.5, 36.9%). In the multivariable logistic regression analysis, being from a largely rural setting (adjusted Odds Ratio (aOR) 1.73, 95% CI 1.10, 2.71; p = 0.02), underweight (aOR 1.87, 95% CI 1.16, 3.01; p = 0.01) and low self-reported ART adherence (aOR 2.83, 95% CI 1.34, 6.00; p = 0.01) were significantly associated with higher odds of VNS in YLWH. Conclusions: In this study, high levels of VNS were observed among YLWH and this was significantly associated with rural residency, nutritional and ART adherence problems. ART adherence counselling and nutritional support and education should be intensified in this setting targeting YLWH residing mostly in rural areas. Given the high frequency of VNS, there is need to closely monitor viral load and profile HIV drug resistance patterns in youths from the Kenyan coast with confirmed virologic failure. The latter will help understand whether drug resistance also contributes to poor viral suppression in addition to, or exclusive of suboptimal ART adherence.

KW - Antiretroviral therapy

KW - HIV infections

KW - Kenya

KW - Prevalence

KW - Risk indicators

KW - Virological non-suppression

KW - Young people

KW - Youths living with HIV

UR - https://www.scopus.com/pages/publications/85129964131

UR - https://www.scopus.com/pages/publications/85129964131#tab=citedBy

U2 - 10.1186/s12879-022-07428-w

DO - 10.1186/s12879-022-07428-w

M3 - Article

C2 - 35545757

AN - SCOPUS:85129964131

SN - 1471-2334

VL - 22

SP - 1

EP - 10

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

M1 - 449

ER -

HIV virological non-suppression is highly prevalent among 18- to 24-year-old youths on antiretroviral therapy at the Kenyan coast

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

Persistent URL (handle)

Other files and links

Fingerprint

Cite this