Household-Based Factors Associated with Viral Load Suppression Among Adolescents Living with HIV in Western Kenya

Background: Despite global efforts to reach a 95% viral suppression rate among people with HIV on Antiretroviral therapy (ART), progress has been slower for Adolescents living with HIV (ALHIV). Therefore, identifying the household factors associated with viral suppression among ALHIV could ensure zero HIV transmission and reduce the risk of opportunistic infections, drug resistance and AIDS. Materials And Methods: Using a cross-sectional survey design with a quantitative approach, data was collected from 263 adolescents during their routine clinic visits at a large HIV comprehensive care clinic namely Rafiki Center and Module 4 clinic based at Academic Model Providing Access to Healthcare (AMPATH). Respondents were identified using a systematic random sampling technique. A structured questionnaire was used to assess the demographic and household factors associated with viral suppression. The viral load data was obtained from the Electronic Medical Records. Results: Of the 263 adolescents, 85.6% (n=225) were virally suppressed. Participants who talked freely with caregivers/parents about HIV status (AOR=3.10, 95%CI=1.40-8.92), getting reminders from their caregivers to take ART (AOR=2.15, 95%CI=1.59-5.22) and were getting financial support to facilitate their transport to the facility (AOR=2.33, 95%CI=1.82-6.65). Additionally, those who joined a social support group (AOR=3.82, 95%CI=1.20-12.15) and who took less than 60 minutes to reach the health facility (AOR=3.16, 95%CI=1.29-7.74) had higher odds of viral suppression. Participants whose level of education was at least secondary school (AOR=6.87, 95%CI=2.40-19.64) and who lived with both parents (AOR=5.0, 95%CI=1.66-15.09) had higher odds of viral suppression. The odds of becoming virally suppressed were lower among older adolescents (AOR=0.62, 95%CI=0.47- 0.82). Conclusion: Viral suppression levels approached but did not meet 2030 targets. Stable living conditions, strong family relationships, communication, and social support were linked to improved viral suppression. Integrating these household factors into HIV care is crucial for enhancing viral suppression among ALHIV. Implementing family empowerment models through further studies can inform effective policy interventions.