Journal of Community Medicine & Health Education
Open Access

Abstract

Introduction & Aim: Virological failure is a public health problem in resource constrained settings. A review of clinical data between January and June 2017 in Bindura and Shamva Districts revealed that 120 (49.6%) of the 200 HIV positive adolescents had virological failure. This may threaten the attainment of the target of 90% viral load suppression by the year 2020. Therefore a study is to determine the factors associated with virological failure among adolescents in Bindura and Shamva districts were done. Materials & Methods: A 1:1 unmatched case-control study was conducted. A case was an adolescent from Bindura and Shamva Districts who has been on ART for at least 6 months and had a repeat viral load of >1000 copies/ml. Pretested interview administered questionnaire was used to collect data randomly from participants. Ethical approval was obtained from the Medical Research Council of Zimbabwe. Logistic regression was done to identify independent risk factors. Results: We recruited 164 study participants (82 cases and 82 controls). Significant independent risk factors for virological failure among adolescents in Shamva and Bindura were: psychosocial problems (AOR=3.01, 95%, CI=2.56-5.60), being on ART for more than 5 years (AOR 2.3, 95%, CI=2.8-10.8) and a baseline viral load of more than 1000 copies/ml (AOR 2.7, 95%CI=1.7-4.2). Having a treatment buddy (AOR=0.06, 95% CI=0.001-0.4) was the most significant protective factor. Conclusion: Psychosocial problems were strongly associated with virological failure among adolescents in Shamva and Bindura Districts. We recommended on strengthening community programs on disclosure of HIV among adolescents to improve treatment outcomes.

Biography

Auxillia Masunda is a Zimbabwean state-registered nurse and public health practitioner who has over 15 years of experience in the health sector. She has held various posts in Zimbabwe’s Ministry of Health and Child Care; initially as a nursing sister and then in various other capacities including a research nurse, voluntary counsellor and then public health officer. Her career interests are in community health, adolescent health and sexual reproductive health. Auxillia’s career highlights include participation in the development of Zimbabwe’s Protocol for Influenza Sentinel Surveillance and research work in various public health topics in which findings were presented locally and nationally. Auxillia holds a Master of Public Health Degree from Africa University, a Bachelor in Community and Health Psychology degree from the University of South Africa, Sexual Gender Based Violence Certificate, Certificate in Systemic Counselling in Context of HIV/AIDS and a Diploma in General Nursing. Currently, Auxillia is employed by the City of Harare’s Department of Health as a Sister in Charge at Wilkins Infectious Diseases Hospital.

E-mail: auxmasunda2@gmail.com