Factors Associated with Viral Load Suppression Among People Living with HIV on Antiretroviral Therapy in Bunia, Northeastern Democratic Republic of Congo

Abstract

Background: The fight against HIV in the Democratic Republic of Congo (DRC) is hindered by systemic challenges; notably, limited access to HIV viral load (VL) testing. Achieving VL suppression is the primary global target for eliminating HIV as a public health threat by 2030. This study aimed to determine the rate of VL suppression and identify associated factors among people living with HIV (PLHIV) receiving antiretroviral therapy (ART) in Bunia. Methods: A descriptive and analytical cross-sectional study was conducted among PLHIV receiving care at treatment sites in Bunia over a period of 11 months. Participants were selected using a two-stage sampling approach, consisting of non-random quota sampling followed by simple random sampling. The primary endpoint was the proportion of PLHIV achieving VL suppression, while associated factors were identified using multiple logistic regression analysis. Results: Overall, 603 PLHIV were enrolled, including 180 males (29.9%) and 423 females (70.1%). The median age was 40 years (IQR: 32–48), median duration on ART was 38 months (IQR: 15–91), and VL suppression was achieved by 75% of the participants. While this indicates significant progress, it remains below the UNAIDS 95-95-95 targets. Adherence to antiretroviral therapy (aOR = 139.43; 95% CI: 66.63–291.76; p < 0.001) and being female (aOR = 2.15; 95% CI: 1.02–4.53; p = 0.044) emerged as independent predictors of virological success. Conclusions: Enhancing access to VL testing and optimizing ART adherence support strategies are critical to improving VL suppression rates in Bunia. Addressing these gaps is essential for the DRC to align with the global health objectives.