article · BMC Infectious Diseases
Routine viral load data from 31,288 records tested at the Kaoma PCR Laboratory across seven districts in Western Province, Zambia, show an overall virological suppression rate of 93.4 percent among people living with HIV on antiretroviral therapy. Analysis revealed notable disparities across demographic groups and facilities. Adults aged 25 and older achieved the highest suppression rate at 94.3 percent, whereas children aged zero to four years recorded the lowest at 83.1 percent. Female clients demonstrated higher suppression levels than males. Across districts, suppression rates ranged between 91 percent and 95 percent. Despite these broad achievements, only 30 out of 140 health facilities met the UNAIDS target of at least 95 percent viral suppression, highlighting critical localized gaps in treatment monitoring and outcomes.
Achieving widespread virological suppression is vital to halting HIV transmission and enhancing patient survival. Although high overall suppression rates show substantial progress toward global targets, persistent deficits among children, men, and specific local health centres indicate where health systems must focus resources to close remaining gaps.
The abstract does not indicate a commercialisation pathway, focusing instead on epidemiological surveillance and public health programme optimisation within routine public healthcare facilities.
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Achieving and sustaining virological suppression among people living with HIV (PLHIV) receiving antiretroviral therapy (ART) is essential for improving clinical outcomes, reducing HIV transmission, and achieving the UNAIDS 95-95-95 targets. Although Zambia has expanded routine viral load (VL) monitoring, disparities in virological suppression persist across districts. This study assessed virological suppression among PLHIV whose routine VL samples, collected from health facilities in seven districts of Western Province and tested at the Kaoma PCR Laboratory, using routine laboratory data from January to December 2025 to characterize geographic variation and inform targeted HIV program interventions. We conducted a retrospective cross-sectional study using de-identified routine HIV viral load records from the Kaoma PCR Laboratory for seven districts in Western Province, Zambia, between January and December 2025. Virological suppression was defined as a plasma viral load of < 1,000 copies/mL. Descriptive statistics were used to summarize participant characteristics and viral load suppression. Differences in suppression by age and sex were assessed using Pearson’s chi-square test, while district-level variation was visualized using geographic information system (GIS) mapping. A total of 31,288 routine VL records were analysed, of which 22,386 (71.6%) were from females and 27,779 (88.7%) were from adults aged ≥ 25 years. Overall, 93.4% (95% CI: 93.2–93.7) of clients achieved virological suppression (< 1,000 copies/mL). Virological suppression differed significantly by age (χ² = 311.49, p < 0.001), with the highest suppression among adults aged ≥ 25 years (94.3%; 95% CI: 94.0–94.6) and the lowest among children aged 0–4 years (83.1%; 95% CI: 76.3–88.3). Suppression was also significantly higher among females than males (94.1% vs. 91.8%; χ² = 54.74, p < 0.001). All seven districts achieved suppression rates above 91%, ranging from 91% in Sikongo to 95% in Nkeyema. However, only 30 of 140 (21.4%) health facilities achieved the UNAIDS target of ≥ 95% viral suppression. Virological suppression was high among PLHIV receiving routine viral load testing in the seven study districts. However, lower suppression among children, adolescents, young adults, males, and many health facilities highlights the need for targeted interventions to improve treatment outcomes and achieve the UNAIDS viral suppression target. Not applicable.
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DOI: 10.1186/s12879-026-14328-w
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