Abstract

Globally, a significant number of people were living with HIV in 2022, with a substantial proportion receiving antiretroviral therapy (ART). Despite these advancements, HIV continues to pose a serious challenge to global health. Against this backdrop, this study evaluated CD4 T-lymphocytes, adherence, and sociodemographic factors associated with the current viral load outcome of People Living with HIV (PLHIV) on ART in Lagos State, Nigeria, supported by the USAID-funded project - Accelerating the control of HIV Epidemic in Nigeria, Cluster 6 (ACE-6). The study utilized a retrospective design to study 19,183 registered people living with HIV (PLHIV) receiving ART on the ACE 6 project in Lagos, Nigeria. The end-line data of the PLHIV formed the basis of the analysis using Binary Logistic Regression at a 5% significance level. The analysis was facilitated using SPSS version 23 software. The results showed an average age of 41.28±20.07 while there was no significant association between multimonth dispensing (MMD) duration and viral load outcome among the patients (χ2 = 7.583, df = 5, p = 0.181). Socio-demographic factors like Apapa residence (OR: 1.511), Surulere (OR: 1.461), and Kosofe (OR: 1.573) were significantly associated with the last viral load suppression (VLS) Outcome. Primary level education (UOR: 0.000) and being employed (OR: 0.804) predicted (VLS). However, gender was not significantly associated with VLS. Patients who poorly adhered to ART (OR: 0.852) were significantly less likely to achieve viral suppression than those with good adherence. However, CD4 cell counts were not an independent predictor of viral load suppression. The study concludes that poor adherence to ART significantly reduces the likelihood of viral suppression among people living with HIV (PLHIV). At the same time, CD4 cell counts are not independent predictors of viral load suppression. Therefore, it is recommended to enhance adherence strategies to improve viral suppression outcomes among registered hospital-based HIV patients. Additionally, targeted interventions should consider socio-demographic factors such as residence and employment outcomes to further support viral load suppression efforts.

Key words: Viral load suppression, antiretroviral therapy (ART) adherence, CD4 cell counts.