Virological suppression and descriptive clinical characteristics among adolescents and young adults living with HIV in a tertiary facility in South Eastern, Nigeria: an exploratory cross sectional study

Abstract

Achieving viral suppression(VS) is the primary aim of combination antiretroviral therapy (ART) for adolescents and young adults (AYA). This study explores viral suppression and associated characteristics of AYA living with HIV on ART in South Eastern Nigeria. A cross-sectional study was conducted among 92 consenting AYA aged 10–22 years at the HIV clinic of Federal Teaching Hospital Owerri, Nigeria. A structured questionnaire was utilized to collect sociodemographic (educational level, orphan status, SEC), HIV-related knowledge and ART use, data. Self-reported adherence (3 days visual analogue scale) was obtained and viral load (VL) was extracted from the electronics records. Analyses employed Spearman’s rank correlation, Mann‑Whitney U and Kruskal‑Wallis tests. The 92 AYA recruited into the study, had a median age of 15.7 years(SD ± 2.7),a median ART duration of 10 years (IQR: 5–14). Among 83 participants with VL results, 80 (96.4%) achieved viral suppression (< 1000 copies/mL); 3 (3.6%) were unsuppressed. Median VL was 20copies/mL (IQR: 19–20).Self-reported adherence was 92.4%.Socioeconomic status (SES) was significantly associated with viral load ( p = 0.039). No significant associations were found between VS and sex, orphan status, age, or self-reported adherence. Notably, only 13.0% of participants had disclosed their HIV status. This group demonstrates high virological suppression rate, reflecting effective ART programmatic delivery. However, the absence of a statistically significant association between self-reported adherence and suppression; likely due to limited statistical power from only three unsuppressed cases and the concurrent low disclosure rate of 13.0% reveals critical psychosocial vulnerabilities. These findings support the need for integration of structured, adolescent friendly interventions into standard HIV care in the clinics.