Achieving viral suppression among adolescents living with HIV: programmatic and clinical determinants from a multicentre study in Lubumbashi, Democratic Republic of the Congo
1
Community Health, Institut Supérieur des Techniques Médicales de Lubumbashi, Lubumbashi, Congo, Democratic Republic of the
2
Health Economics and HIV/AIDS Research Division (HEARD), University of Kwazulu-Natal, Durban, South Africa
3
Department of Pediactrics, University of Lubumbashi, Lubumbashi, Congo, Democratic Republic of the
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Achieving viral load suppression is essential for effective HIV control and improved clinical outcomes. However, adolescents living with HIV remain a particularly vulnerable group, often experiencing suboptimal treatment outcomes. This is especially true in many sub-Saharan African settings [1], including the Democratic Republic of the Congo (DRC), where evidence on the determinants of viral suppression among adolescents is limited. Understanding these determinants is critical to inform targeted interventions. Therefore, this study aimed to determine the rate of viral load suppression and to identify clinical and programmatic factors associated with viral suppression among adolescents receiving antiretroviral therapy (ART) in Lubumbashi, DRC.
METHODS:
We conducted a multicentre retrospective cross-sectional study from June to September 2024 in 21 HIV care clinics in Lubumbashi. Adolescents aged 10–19 years on ART for at least six months with at least one viral load (VL) result were included (n=529). Data were extracted from medical records using a standardized checklist. Multivariable logistic regression was used to identify factors independently associated with viral suppression (p<0.05).
RESULTS:
The mean age of participants was 14.8 ± 3.0 years, and 60.1% were female. Overall, 69.4% of adolescents achieved viral load suppression, while 30.6% had unsuppressed viral load. In multivariable analysis, viral suppression was independently associated with good treatment adherence (aOR=72.1; 95% CI: 33.1–156.9; p<0.001), receipt of isoniazid preventive therapy (aOR=6.5; 95% CI: 1.9–21.4; p=0.002), early WHO clinical stage I–II (aOR=2.5; 95%CI: 1.0–6.2; p=0.041), use of dolutegravir-based ART regimens (aOR=5.7; 95% CI: 2.1–15.7; p=0.001), absence of ART-related side effects (aOR=3.3; 95%CI: 1.5–7.0; p=0.003), and vertical HIV transmission (aOR=2.1; 95%CI: 1.0–4.5; p=0.052).
CONCLUSIONS:
Approximately seven in ten adolescents on ART in Lubumbashi achieved viral suppression. Key determinants included adherence, preventive therapy, early clinical management, treatment tolerability, and dolutegravir-based regimens. Strengthening adolescent-friendly, differentiated HIV care is critical to closing remaining gaps in viral suppression.
Achieving viral load suppression is essential for effective HIV control and improved clinical outcomes. However, adolescents living with HIV remain a particularly vulnerable group, often experiencing suboptimal treatment outcomes. This is especially true in many sub-Saharan African settings [1], including the Democratic Republic of the Congo (DRC), where evidence on the determinants of viral suppression among adolescents is limited. Understanding these determinants is critical to inform targeted interventions. Therefore, this study aimed to determine the rate of viral load suppression and to identify clinical and programmatic factors associated with viral suppression among adolescents receiving antiretroviral therapy (ART) in Lubumbashi, DRC.
METHODS:
We conducted a multicentre retrospective cross-sectional study from June to September 2024 in 21 HIV care clinics in Lubumbashi. Adolescents aged 10–19 years on ART for at least six months with at least one viral load (VL) result were included (n=529). Data were extracted from medical records using a standardized checklist. Multivariable logistic regression was used to identify factors independently associated with viral suppression (p<0.05).
RESULTS:
The mean age of participants was 14.8 ± 3.0 years, and 60.1% were female. Overall, 69.4% of adolescents achieved viral load suppression, while 30.6% had unsuppressed viral load. In multivariable analysis, viral suppression was independently associated with good treatment adherence (aOR=72.1; 95% CI: 33.1–156.9; p<0.001), receipt of isoniazid preventive therapy (aOR=6.5; 95% CI: 1.9–21.4; p=0.002), early WHO clinical stage I–II (aOR=2.5; 95%CI: 1.0–6.2; p=0.041), use of dolutegravir-based ART regimens (aOR=5.7; 95% CI: 2.1–15.7; p=0.001), absence of ART-related side effects (aOR=3.3; 95%CI: 1.5–7.0; p=0.003), and vertical HIV transmission (aOR=2.1; 95%CI: 1.0–4.5; p=0.052).
CONCLUSIONS:
Approximately seven in ten adolescents on ART in Lubumbashi achieved viral suppression. Key determinants included adherence, preventive therapy, early clinical management, treatment tolerability, and dolutegravir-based regimens. Strengthening adolescent-friendly, differentiated HIV care is critical to closing remaining gaps in viral suppression.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
