Predictors of durable viral suppression among people living with HIV (PLHIV) on antiretroviral treatment in Almaty, Kazakhstan

The HIV epidemic is steadily increasing in Eastern Europe and Central Asia. In Kazakhstan, key at-risk populations and their sexual partners are disproportionately impacted. Achieving the UNAIDS 95-95-95 targets is a critical priority to effectively control and ultimately end the HIV epidemic in the country. We used data from the AIDS Center in Almaty to assess the predictors associated with durable HIV viral suppression. A total of 2540 PLHIV receiving ART were included in the analysis. PLHIV who maintained ≥95% adherence level had greater odds of maintaining viral suppression (aOR 13.3, 95% CI (9.45, 18.58)). PLHIV who acquired the virus via injection drug use (aOR 0.73, 95% CI (0.58, 0.93)), who were cohabitating (aOR 0.66, 95% CI (0.48, 0.92)), or who had been on ART 1-5 years (aOR 0.65, 95% CI (0.52, 0.81)) had lower odds of being durably suppressed. This study provides valuable insights to optimize HIV care in Almaty and support the further refinement of the test-and-treat strategy implementation. Starting PLHIV on ART is crucial, but to achieve the positive effects of ART, adherence is also important. This is the first large -scale study to report on factors associated with HIV viral suppression in Kazakhstan.