Virologic and Immunological Failure and Associated Factors Among Adults Living With HIV on HAART at Jimma Medical Center, Southwest Ethiopia

Background Antiretroviral therapy reduces HIV morbidity, mortality, viral replication, and transmission, and viral load testing is the preferred method for monitoring effectiveness. This study assessed virologic and immunologic failure and associated factors among adults living with HIV on HAART at Jimma Medical Center, southwest Ethiopia. Methods An institution-based cross-sectional study was conducted from February to March 2019 among 272 adults on HAART. Data were collected from medical records and structured interviews. CD4+ T-cell counts and plasma viral loads were measured using standard laboratory procedures. Data were analyzed using SPSS version 24. Descriptive statistics summarized the data, and bivariate and multivariate logistic regression analyses were performed to identify associated factors. Multicollinearity was assessed before the final model. Adjusted odds ratios (AORs) with 95% confidence intervals were reported, and a P -value <.05 was considered statistically significant. Results Of the participants, 60.7% were female, with a mean age of 36.6 years and a median ART duration of 96 months. Immunologic failure occurred in 8.1% and virologic failure in 10.3%. Immunologic failure was associated with tuberculosis co-infection and poor ART adherence. Virologic failure was associated with poor adherence, baseline viral load ≥1000 copies/mL, and CD4+ count <250 cells/mm 3 . Conclusion Adherence support remains essential for viral suppression.