Clinical factors Associated with Viral Load Suppression Among HIV and AIDS - Positive Children (0 – 14 Years) Attending Meru County Referral Hospital, Meru County, Kenya

Abstract

Viral load suppression among children living with Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) is critical to sustaining quality of life, preventing treatment failure, achieving optimal ART outcomes, and preventing the transmission of multi-drug-resistant virus later in life. Children aged 0 - 14 years are disproportionately more affected by poor viral load suppression than adolescents, suggesting that this age group requires specific attention. This study sought to determine the clinical factors affecting viral load suppression in pediatric HIV and AIDS care in Meru County Referral Hospital. A descriptive cross-sectional survey was conducted among caregivers of children living with HIV and AIDS attending Meru Referral Hospital, supplemented by the interview of 10 key informants (healthcare workers). Structured pretested questionnaires and interview guides were used for collecting both quantitative and qualitative data. The quantitative data collected was analyzed and interpreted using statistical methods and approaches using the SPSS version 30.0.0 statistical software. The median age of caregivers was 34 years (IQR = 28). The study findings indicated a significant proportion of children initiated antiretroviral therapy (ART) early in life. Specifically, 102 (86.4%) of the children commenced ART treatment between the ages of 0–4 years. A smaller proportion, 8 (6.8%), began ART between the ages of 5–9 years, and another 8 (6.8%) initiated treatment between 10– 14 years. The significant clinical predictors of viral load suppression were disclosure status, age at disclosure, and number of hospitalizations. To address these factors affecting viral load suppression, the study recommends strengthening age-appropriate HIV disclosure interventions, enhancing ART adherence monitoring and caregiver counseling, and ensuring continuity of ART and supply chain management.