This study aimed to elucidate gender disparities and state dynamics in Human Immune Virus (HIV) viral suppression within the context of Southern Nigeria on the USAID-funded project Accelerating Control of HIV/AIDS Epidemic (ACE) in Nigeria, cluster 6 (ACE 6). The study employed an ex post facto research design while using multiple logistic regression to analyze patient level data of active People Living with HIV (PLHIV) in Bayelsa, Edo and Lagos in Southern Nigeria. The dataset encompassed a diverse sample, offering a comprehensive understanding of the complex interplay of factors influencing viral suppression. The results indicated a notable gender-based discrepancy, wherein females demonstrated a higher probability of having virally unsuppressed status compared to males (OAR: 1.638; CI: 1.382-1.942). Marital status played a significant role, particularly for separated individuals, who exhibited an elevated likelihood of virally unsuppressed status (AOR: 1.383; CI: 1.000-1.913). Geographical variations were evident, with residents in Edo (AOR: 0.358; CI: 0.254-0.504) and Lagos (AOR: 0.733; CI: 0.545-0.987) States having a reduced likelihood of achieving virally suppressed status compared to Bayelsa. The temporal dimension introduced by the duration of Multimonth Dispensing revealed 60 days (AOR: 1.144; CI: 1.008-1.299) being associated with an increased likelihood of virally unsuppressed outcome, while 180 days (0.797; CI: 0.729-0.871) was linked to a decreased likelihood of virally unsuppressed status. The study shed light on the intricate relationships between selected demographic variables and viral suppression outcomes among PLHIV in Southern Nigeria. The findings provide valuable insights for building biomedical models of understanding and intervention in the context of HIV care in Southern Nigeria.

Keywords: : Gender-Based Disparity, Viral load outcome, Multimonth dispensing duration, Marital status influence, State variances.