scholarly journals Factors Associated with the Effectiveness of National Free Antiretroviral Treatment Program in HIV Infected Patients of Yi Nationality from Southwest China: Evidence from A Cohort Study to Provide Clues for Improvement

2020 ◽  
Author(s):  
Liyu Chen ◽  
Shuang Kang ◽  
Lingyao Du ◽  
Fanghua Ma ◽  
Changmin Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Treatment Program ◽  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Fasting Blood Glucose ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Immune Recovery ◽  
Limited Region

Abstract Background: Despite the current achievements of HIV management in the source-limited region of Liangshan Autonomous Prefecture, a small population remains with unsatisfactory virologic outcomes and suboptimal immune recovery. This cohort study aimed to identify potential risk factors of suboptimal clinical outcomes and to provide clues for improvement in people living with HIV (PLWH) from China’s National Free Antiretroviral Treatment Program (NFATP) in Zhaojue County, Liangshan Autonomous Prefecture of Yi nationality. Results: A total of 608 HIV infected adult patients in NFATP at the median age of 35(31, 40) were enrolled for analysis. During the 2.15(1.54, 4.00)-year follow-up, 502 (82.6%) patients achieved the viral load of <1000 copies/mL after over 6 months of antiretroviral therapy(ART). Among them, 398 (65.5%) cases achieved complete viral suppression with viral load <50 copies/mL while 104 (17.1%) cases remained with low level viremia (LLV, 50≤ viral load ≤1000 copies/mL). Patients with longer infection duration (OR =1.017 [95%CI: 1.002-1.033], p = 0.026), male gender (OR =1.632 [95%CI: 1.053-2.53], p = 0.028), positive hepatitis C virus antibody (OR =1.687 [95%CI: 1.093-2.604], p = 0.018) or infection through injecting drug use (IDU) (OR =1.584 [95%CI: 1.022-2.455], p = 0.04) were more likely to experience the undesirable outcome of LLV. Moreover, 254 (63.8%) of 398 patients with viral suppression achieved optimal immune recovery with the CD4 count ≥ 350 cells/μL. Patients with lower body mass index (BMI) (21.00±2.94 Kg/m 2 , OR=0.921 [95%CI: 0.854-0.994], p = 0.034) and higher fasting blood glucose (4.99±1.01 mmol/L, OR=1.343 [95%CI: 1.087-1.658], p = 0.006) were less likely to achieve the CD4 count ≥ 350 cells/μL after viral suppression. Conclusions: In this long-term cohort study of PLWH from Zhaojue County, Liangshan, most patients achieved virologic success on ART provided by NFATP but optimal immune recovery was yet to be expected. Approaches including strict control of illegal drug deal, patient education, and nutritional status management could be conducive to better prognosis for this population.

scholarly journals Long-term outcomes of early initiated antiretroviral therapy in sub-Saharan children: a Cameroonian cohort study (ANRS-12140 Pediacam study, 2008–2013, Cameroon)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Francis Ateba Ndongo ◽  
Mathurin Cyrille Tejiokem ◽  
Calixte Ida Penda ◽  
Suzie Tetang Ndiang ◽  
Jean-Audrey Ndongo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Virologic Response ◽  
Sub Saharan Africa ◽  
Factors Associated ◽  
Sub Saharan

Abstract Background In most studies, the virological response is assessed during the first two years of antiretroviral treatment initiated in HIV-infected infants. However, early initiation of antiretroviral therapy exposes infants to very long-lasting treatment. Moreover, maintaining viral suppression in children is difficult. We aimed to assess the virologic response and mortality in HIV-infected children after five years of early initiated antiretroviral treatment (ART) and identify factors associated with virologic success in Cameroon. Methods In the ANRS-12140 Pediacam cohort study, 2008–2013, Cameroon, we included all the 149 children who were still alive after two years of early ART. Virologic response was assessed after 5 years of treatment. The probability of maintaining virologic success between two and five years of ART was estimated using Kaplan-Meier curve. The immune status and mortality were also studied at five years after ART initiation. Factors associated with a viral load < 400 copies/mL in children still alive at five years of ART were studied using logistic regressions. Results The viral load after five years of early ART was suppressed in 66.8% (60.1–73.5) of the 144 children still alive and in care. Among the children with viral suppression after two years of ART, the probability of maintaining viral suppression after five years of ART was 64.0% (54.0–74.0). The only factor associated with viral suppression after five years of ART was achievement of confirmed virological success within the first two years of ART (OR = 2.7 (1.1–6.8); p = 0.033). Conclusions The probability of maintaining viral suppression between two and five years of early initiated ART which was quite low highlights the difficulty of parents to administer drugs daily to their children in sub-Saharan Africa. It also stressed the importance of initial viral suppression for achieving and maintaining virologic success in the long-term. Further studies should focus on identifying strategies that would enhance better retention in care and improved adherence to treatment within the first two years of ART early initiated in Sub-Saharan HIV-infected children.

scholarly journals Impact of age on CD4 recovery and viral suppression over time among adults living with HIV who initiated antiretroviral therapy in the African Cohort Study

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Emmanuel Bahemana ◽  
◽  
Allahna Esber ◽  
Nicole Dear ◽  
Kavitha Ganesan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Viral Suppression ◽  
Cd4 Count ◽  
Age Group ◽  
Art Initiation ◽  
Living With Hiv ◽  
Over Time

Abstract Introduction With increased use of antiretroviral therapy (ART), HIV mortality rates are declining and people living with HIV (PLWH) are surviving longer. We characterized CD4 recovery and viral suppression among adults aged < 50 and ≥ 50 years living with HIV who initiated ART in the African Cohort Study (AFRICOS). Methods Beginning in January 2013, PLWH at twelve clinics in Kenya, Uganda, Tanzania and Nigeria underwent medical history review, CD4 and viral load testing as part of the ongoing African Cohort Study (AFRICOS). ART-naïve PLWH who initiated ART within 30 days of enrollment and had at least one year of follow-up were included in these analyses. To compare ART response in participants < 50 years and ≥ 50 years old, changes in CD4 count and viral load suppression after ART initiation were examined at different time points using linear and binomial regression with generalized estimating equations. Variables for time since ART initiation and the interaction between age group and time on ART were included in the model to evaluate longitudinal changes in CD4 recovery and viral suppression by age. Results Between January 2013 and September 2019, 2918 PLHV were enrolled in the cohort. Of these, 443 were ART naïve and initiated on ART within 30 days of enrollment, with 90% (n = 399) aged < 50 years old at ART initiation. At ART initiation, participants aged 50 and older had a higher median CD4 count compared to participants younger than 50 years of age although it did not reach statistical significance (306 cells/mm3, IQR:130–547 vs. 277cells/mm3, IQR: 132–437). In adjusted models examining CD4 recovery and viral suppression there were no significant differences by age group over time. By the end of follow-up viral suppression was high among both groups of adults (96% of adults ≥ 50 years old and 92% of adults < 50 years old). Conclusion This study found no difference in long-term CD4 recovery or viral suppression by age at ART initiation. We found that particularly among younger adults participants had lower median CD4 counts at ART initiation, suggesting the importance of identifying and putting this population on treatment earlier in the disease course.

scholarly journals Long-term outcomes of early initiated antiretroviral therapy in sub-Saharan children: A Cameroonian cohort study

2020 ◽  
Author(s):  
Francis Ateba Ndongo ◽  
Mathurin Cyrille TEJIOKEM ◽  
Calixte IDA PENDA ◽  
Suzie TETANG NDIANG ◽  
Jean-Audrey NDONGO ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Virologic Response ◽  
Factors Associated ◽  
Kaplan Meier ◽  
Sub Saharan

Abstract Background In most studies, the virological response is assessed during the first two years of antiretroviral treatment initiated in HIV-infected infants. However, early initiation of antiretroviral therapy exposes infants to very long-lasting treatment. Moreover, maintaining viral suppression in children is difficult. We aimed to assess the virologic response and mortality in HIV-infected children after five years of early initiated antiretroviral treatment (ART) and identify factors associated with virologic success in Cameroon. Methods In this cohort study, we included 149 children who were still alive after two years of early ART. Virologic response was assessed after 5 years of treatment. The probability of maintaining virologic success between two and five years of ART was estimated using Kaplan-Meier curve. Factors associated with a viral load < 400 copies/mL in children still alive at five years of ART were studied using logistic regressions. Results The viral load after five years of early ART was suppressed in 66.8% [60.1–73.5] of the 144 children still alive and in care. Among the children with viral suppression after two years of ART, the probability of maintaining viral suppression after five years of ART was 64.0% [54.0–74.0]. The only factor associated with viral suppression after five years of ART was achievement of confirmed virological success within the first two years of ART [OR = 2.7 (1.1–6.8); p = 0.033]. Conclusions This study reported difficulty in maintaining virologic success in sub-Saharan HIV-infected children between two and five years of early initiated ART. It also highlighted the importance of initial viral suppression for achieving and maintaining virologic success in the long-term.

scholarly journals Viral suppression among HIV-positive patients on antiretroviral therapy in northwestern Nigeria: an eleven-year review of tertiary care centre records, January 2009–December 2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suleiman Bello Abdullahi ◽  
Olayinka Rasheed Ibrahim ◽  
Abdulkadir Baba Okeji ◽  
Rabilu Iliyasu Yandoma ◽  
Ibrahim Bashir ◽  
...  
Keyword(s):  
Viral Load ◽  
Viral Suppression ◽  
Treatment Success ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
First Line ◽  
Tertiary Care Centre ◽  
Cross Sectional

Abstract Background Human Immuno-Deficiency Virus (HIV) remains one of the world’s significant public health challenges. Viral suppression is the key indicator for treatment success in People living with HIV (PLHIV). We determined the level of viral suppression, and its associated factors among PLHIV attending Federal Medical Centre Katsina (FMC Katsina), Nigeria. Methods This retrospective descriptive cross-sectional study was conducted on 913 HIV positive adults enrolled in care between January 2009 and December 2019. Information on socio-demographics, clinical, immunological, Viral load (VL), and other relevant parameters were extracted from the patients’ care records. The primary outcome was the proportion of patients that achieved viral suppression. We also analyzed variables that were associated with VL suppression. Results Of 913, records of 831 (91.0%) registered patients were analyzed. During the period, 751 (90.4%) achieved viral suppression, 427 (51.4%) had CD4 counts  ≥ 500 and 477 (57.4%) were on HAART for ≥ 5 years. Majority, 793 (95.4%) were on first-line HAART regimen (Tenofovir-Lamivudine-Dolutegravir or Abacavir-Lamivudine-Dolutegravir), and 809 (97.4%) in the non-advanced stage (WHO stages 1 and 2). The median (interquartile range) of viral load was 20 (20–40) vs 19,989 (3311–110,340) cp/ml in virally suppressed, and unsuppressed  respectively. Factors associated with viral suppression included being unemployed (Adjusted OR [AOR] 4.9, 95% CI 2.771, 8.539), educated (AOR 4.2, 95% CI 1.098, 16.223), having a baseline CD4 count ≥ 500 cells/µl (AOR 2.7, 95% CI 1.588, 4.625), and being on first line HAART regimen [AOR 7.0, 95% CI 3.220, 15.648]. Conclusions Our study demonstrated a good viral suppression among PLHIV on HAART. Variables associated with viral suppression included unemployment, formal education, high baseline CD4 count, and first line HAART regimen.

scholarly journals Determinants of viral suppression among adolescents on antiretroviral treatment in Ehlanzeni district, South Africa: a cross-sectional analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Emeka F. Okonji ◽  
Brian van Wyk ◽  
Ferdinand C. Mukumbang ◽  
Gail D. Hughes
Keyword(s):  
South Africa ◽  
Viral Load ◽  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Multivariate Logistic Regression Analysis ◽  
Cd4 Count ◽  
Second Line ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

Abstract Background Achieving undetectable viral load is crucial for the reduction of HIV transmissions, AIDS-related illnesses and death. Adolescents (10 to19 years) living with HIV (ALHIV) on antiretroviral treatment (ART) have worse treatment adherence and lower viral suppression rates compared to adults. We report on the clinical factors associated with viral suppression among ALHIV in the Ehlanzeni district, Mpumalanga in South Africa. Methods A cross-sectional analysis was conducted with 9386 ALHIV, aged 10 to 19 years, who were enrolled in 136 ART clinics in the Ehlanzeni district. Clinical and immunological data were obtained from electronic medical records (Tier.net). ALHIV were categorised as having achieved viral suppression if their latest viral load count was < 1000 ribonucleic acid (RNA) copies/mL. Using a backward stepwise approach, a multivariate logistic regression analysis was performed to identify factors independently associated with viral suppression. Results The mean age of the participants was 14.75 years (SD = 2.9), and 55.43% were female. Mean duration on ART was 72.26 (SD = 42.3) months. Of the 9386 adolescents with viral load results recorded, 74% had achieved viral suppression. After adjusting for other covariates, the likelihood of achieving viral suppression remained significantly higher among ALHIV who were: female (AOR = 1.21, 95% CI 1.05–1.39), and had most recent CD4 count > 200 (AOR = 2.53, 95% CI 2.06–3.11). Furthermore, the likelihood of having viral suppression was lower among adolescents with CD4 count > 200 at baseline (AOR = 0.73, 95% CI 0.61–0.87), and who were switched to second line regimen (AOR = 0.41, 95% CI 0.34–0.49). Conclusions Viral suppression amongst ALHIV at 74% is considerably lower than the WHO target of 95%. Of particular concern for intervention is the lower rates of viral suppression amongst male ALHIV. Greater emphasis should be placed to early enrolment of ALHIV on ART and keeping them engaged in care (beyond 6 months). Furthermore, improved and regular viral load monitoring will help to adequately identify and manage ALHIV with unsuppressed viral load and subsequently switching to second line treatment.

scholarly journals Treatment outcomes among children younger than five years living with HIV in rural Zambia, 2008–2018: a cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jessica L. Schue ◽  
Janneke H. van Dijk ◽  
Francis Hamangaba ◽  
Mutinta Hamahuwa ◽  
Nkumbula Moyo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
T Cell ◽  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Treatment Initiation ◽  
Cd4 T Cell ◽  
Cell Percentage ◽  
Rural Zambia ◽  
Over Time

Abstract Background HIV testing and treatment guidelines for children in sub-Saharan Africa have evolved over time, such that children are now treated at younger ages. The objective of this study was to describe the treatment experience for immunologic, virologic, and growth outcomes among HIV-infected Zambian children younger than 5 years of age from 2008 to 2018. Methods Participants enrolled in a clinical cohort study in Macha, Zambia and initiating antiretroviral treatment before 5 years of age between 2008 and 2015 were included in the analysis and followed up to the end of 2018. Outcomes, including growth, CD4+ T-cell percentage, viral suppression, and mortality, were evaluated among all children using longitudinal and survival analyses. Comparisons by age at treatment initiation (< 1, 1 to < 2, and 2 to < 5 years) were also evaluated. Results Three hundred eighty-one children initiating treatment before 5 years of age between 2008 and 2015 were included in the analysis. Growth metrics and CD4+ T-cell percentage improved over time after treatment initiation. However, 20% of children remained underweight and 40% of children remained stunted after the first 36 months of treatment. 85% of children had a viral load < 400 copies/mL after 12 months of treatment. However, children < 1 year at treatment initiation were more likely to have a detectable viral load in the first 12 months of treatment and less likely to achieve viral suppression compared to older children. Mortality was highest in the first 12 months of treatment, among underweight children, and among children initiating treatment in 2008–2010 compared to 2011–2015. Conclusions Most children initiating antiretroviral treatment from 2008 to 2015 in rural Zambia responded well to treatment. However, many children remained underweight and stunted, and experienced high mortality rates during the first few months of treatment. This supports continued efforts to improve early infant diagnosis, nutritional support, and pediatric drug formulations.

scholarly journals Long-term outcomes of early initiated antiretroviral therapy in sub-Saharan children: A Cameroonian cohort study

2020 ◽  
Author(s):  
Francis Ateba Ndongo ◽  
Mathurin Cyrille TEJIOKEM ◽  
Calixte IDA PENDA ◽  
Suzie TETANG NDIANG ◽  
Jean-Audrey NDONGO ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Virologic Response ◽  
Factors Associated ◽  
Kaplan Meier ◽  
Sub Saharan

Abstract Background: In most studies, the virological response is assessed during the first two years of antiretroviral treatment initiated in HIV-infected infants. However, early initiation of antiretroviral therapy exposes infants to very long-lasting treatment. Moreover, maintaining viral suppression in children is difficult. We aimed to assess the virologic response and mortality in HIV-infected children after five years of early initiated antiretroviral treatment (ART) and identify factors associated with virologic success in Cameroon. Methods: In this cohort study, we included 149 children who were still alive after two years of early ART. Virologic response was assessed after 5 years of treatment. The probability of maintaining virologic success between two and five years of ART was estimated using Kaplan-Meier curve. Factors associated with a viral load < 400 copies/mL in children still alive at five years of ART were studied using logistic regressions.Results: The viral load after five years of early ART was suppressed in 66.8% (60.1 - 73.5) of the 144 children still alive and in care. Among the children with viral suppression after two years of ART, the probability of maintaining viral suppression after five years of ART was 64.0% (54.0 - 74.0). The only factor associated with viral suppression after five years of ART was achievement of confirmed virological success within the first two years of ART (OR = 2.7 (1.1-6.8); p = 0.033).Conclusions: This study reported difficulty in maintaining virologic success in sub-Saharan HIV-infected children between two and five years of early initiated ART. It also highlighted the importance of initial viral suppression for achieving and maintaining virologic success in the long-term.

scholarly journals Predictors of virological failure among people living with HIV receiving first line antiretroviral treatment in Myanmar: retrospective cohort analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anita Mesic ◽  
Alexander Spina ◽  
Htay Thet Mar ◽  
Phone Thit ◽  
Tom Decroo ◽  
...  
Keyword(s):  
Viral Load ◽  
Virological Failure ◽  
Antiretroviral Treatment ◽  
People Living With Hiv ◽  
First Line ◽  
Hiv Viral Load ◽  
Loss To Follow Up ◽  
History Of ◽  
Living With Hiv

Abstract Background Progress toward the global target for 95% virological suppression among those on antiretroviral treatment (ART) is still suboptimal. We describe the viral load (VL) cascade, the incidence of virological failure and associated risk factors among people living with HIV receiving first-line ART in an HIV cohort in Myanmar treated by the Médecins Sans Frontières in collaboration with the Ministry of Health and Sports Myanmar. Methods We conducted a retrospective cohort study, including adult patients with at least one HIV viral load test result and having received of at least 6 months’ standard first-line ART. The incidence rate of virological failure (HIV viral load ≥ 1000 copies/mL) was calculated. Multivariable Cox’s regression was performed to identify risk factors for virological failure. Results We included 25,260 patients with a median age of 33.1 years (interquartile range, IQR 28.0–39.1) and a median observation time of 5.4 years (IQR 3.7–7.9). Virological failure was documented in 3,579 (14.2%) participants, resulting in an overall incidence rate for failure of 2.5 per 100 person-years of follow-up. Among those who had a follow-up viral load result, 1,258 (57.1%) had confirmed virological failure, of which 836 (66.5%) were switched to second-line treatment. An increased hazard for failure was associated with age ≤ 19 years (adjusted hazard ratio, aHR 1.51; 95% confidence intervals, CI 1.20–1.89; p < 0.001), baseline tuberculosis (aHR 1.39; 95% CI 1.14–1.49; p < 0.001), a history of low-level viremia (aHR 1.60; 95% CI 1.42–1.81; p < 0.001), or a history of loss-to-follow-up (aHR 1.24; 95% CI 1.41–1.52; p = 0.041) and being on the same regimen (aHR 1.37; 95% CI 1.07–1.76; p < 0.001). Cumulative appointment delay was not significantly associated with failure after controlling for covariates. Conclusions VL monitoring is an important tool to improve programme outcomes, however limited coverage of VL testing and acting on test results hampers its full potential. In our cohort children and adolescents, PLHIV with history of loss-to-follow-up or those with low-viremia are at the highest risk of virological failure and might require more frequent virological monitoring than is currently recommended.

scholarly journals Community Viral Load and CD4 Count Distribution Among People Living With HIV in a South African Township

2013 ◽  
Vol 63 (4) ◽  
pp. 498-505 ◽  
Author(s):  
Katharina Kranzer ◽  
Stephen D. Lawn ◽  
Leigh F. Johnson ◽  
Linda-Gail Bekker ◽  
Robin Wood
Keyword(s):  
Viral Load ◽  
South African ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Count Distribution ◽  
Living With Hiv ◽  
South African Township

scholarly journals Multilevel of Factors Affected Optimal Adherence to Antiretroviral Therapy and Viral Suppression Amongst HIV-infected Prisoners in South Ethiopia: A Prospective Cohort Study

2021 ◽  
Author(s):  
Terefe Gone Fuge ◽  
George Tsourtos ◽  
Emma R Miller
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
South Ethiopia ◽  
Pharmacy Refill ◽  
Living With Hiv ◽  
Optimal Adherence

Abstract ObjectivesMaintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of treatment adherence and viral suppression in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors amongst prisoners in South Ethiopia. MethodsA prospective cohort study was conducted between June 1, 2019 and May 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information (including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration related characteristics) was collected using a structured questionnaire. Adherence was determined based on the participants’ self-report and pharmacy refill records. Plasma viral load measurements undertaken within the study period were prospectively extracted to determine viral suppression. Univariate and multivariate regression models were used to analyse data. ResultsWhile prisoners had a significantly higher pharmacy refill adherence compared to non-incarcerated PLWHA (89% vs 75%), they had a slightly lower dose adherence (81% vs 83%). The prevalence of viral failure (VF) was also slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31to 35 years and in those who experienced social stigma, regardless of their incarceration status. ConclusionsThis study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to ART doses and to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors were found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

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