Viral load suppression after intensive adherence counselling among previously non-suppressed adolescents and young people with HIV in East-Central Uganda

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dc.contributor.authorEjalu, David Livingstone
dc.contributor.authorOkello, Peter Simon
dc.contributor.authorPuleh, Sean Steven
dc.contributor.authorNangendo, Joanita
dc.contributor.authorIzudi, Jonathan
dc.contributor.authorBakeera-Kitaka, Sabrina
dc.contributor.authorKatamba, Achilles
dc.contributor.authorKatahoire, Anne R
dc.contributor.authorKalyango, Joan N
dc.contributor.authorCattamanchi, Adithya
dc.contributor.authorSemitala, Fred C
dc.contributor.authorKamya, Moses R
dc.date.accessioned2026-03-05T10:04:18Z
dc.date.available2026-03-05T10:04:18Z
dc.date.issued2026-03-03
dc.descriptionThis study examines viral load suppression among adolescents and young people living with HIV in Uganda, revealing how intensive adherence counselling can significantly improve treatment outcomes. By focusing on the lived experiences of youth, the research highlights the personal and social challenges they face, such as stigma, non-disclosure, and long distances to health facilities—all of which can hinder effective HIV management. These findings underscore the need for targeted counselling, improved access to care, and strategies to overcome social and structural barriers, ensuring young people receive the support they need to thrive. The study advances SDG 3 (Good Health and Well-Being) by promoting better HIV treatment outcomes, SDG 10 (Reduced Inequalities) by addressing access challenges among vulnerable youth, and SDG 5 (Gender Equality) by supporting inclusive health services. Aligned with Uganda’s National Development Plan IV, the research calls for a stronger health system, enhanced HIV services, and equitable healthcare access as foundations for youth well-being and national development.
dc.description.abstractBackground: Viral load suppression remains suboptimal among adolescents and young people living with HIV in Uganda (AYPLHIV). Although Intensive Adherence Counselling is recommended for individuals who remain virally non-suppressed while on antiretroviral therapy, its contribution to suppression among AYPLHIV is not well understood. This study aimed to determine the level of viral load suppression achieved following intensive adherence counselling among previously non-suppressed AYPLHIV in east central Uganda. Methods: We conducted a sequential explanatory mixed methods study among 580 participants aged 10– 24 years receiving care at 32 health facilities. Quantitative data were abstracted covering a five-year period from 2019– 2024. Suppression levels and subgroup differences were assessed using chi-square tests. A qualitative study was conducted with 12 purposively selected participants and thematic analysis were guided by the Capability, Opportunity, Motivation and Behavior framework. Results: Participants had a median age of 16.4 years and a median ART duration of 4 years. Overall, out of the 580 participants, 313 (53.9%) achieved viral load suppression after counselling. Participants living more than 5 km compared to less than 5km from a health facility (p=0.003) and those counselled by counsellors rather than nurses (p< 0.001) had significantly higher suppression level. Lower suppression level was observed among participants who had not disclosed their HIV status versus those who disclosed (p=0.011) and those reporting fear or stigma compared to those not reporting (p=0.010). Qualitative findings indicated that understanding the purpose and benefits of intensive adherence counselling (Capability), financial barriers and provider interactions (Opportunity), and non-disclosure (Motivation) influenced suppression outcomes among AYPLHIV. Conclusion: IAC resulted in modest improvements in VL suppression among AYPLHIV. Low retention and contextual barriers, including distance, stigma and non-disclosure, limited its effectiveness. Tailored IAC strategies addressing subgroup-specific barriers are needed to improve VL suppression.
dc.description.sponsorshipFogarty International Centre, the National Institute of Mental Health, and the Office of AIDS Research of the U.S. National Institutes of Health (NIH), through Award Number D43 TW010037.
dc.identifier.citationEjalu DL, Okello PS, Puleh SS, Nangendo J, Izudi J, Bakeera-Kitaka S, Katamba A, Katahoire AR, Kalyango JN, Cattamanchi A, Semitala FC, Kamya MR. (2026). Viral Load Suppression After Intensive Adherence Counselling Among Previously Non-Suppressed Adolescents and Young People with HIV in East-Central Uganda. HIV/AIDS - Research and Palliative Care, 18. https://doi.org/10.2147/HIV.S588885
dc.identifier.issn1179-1373
dc.identifier.urihttps://dir.muni.ac.ug/handle/20.500.12260/932
dc.language.isoen_US
dc.publisherTaylor & Francis
dc.subjectViral load suppression
dc.subjectIntensive adherence counselling
dc.subjectART adherence
dc.titleViral load suppression after intensive adherence counselling among previously non-suppressed adolescents and young people with HIV in East-Central Uganda
dc.typeArticle

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