Viral load suppression after enhanced adherence counseling and its associated factors among clients on antiretroviral therapy

Background Maintaining long-term client adherence and viral suppression requires ongoing increased adherence counseling and follow-up care. Promoting enhanced adherence counseling (EAC) is advised for those whose viral load is greater than or equivalent to 1000 copies/ml. However, there is still a lack of knowledge in the study region about the degree of viral load suppression that occurs after enhanced adherence counseling is implemented. Objective The study was to determine the magnitude of Viral load suppression after enhanced adherence counseling and its associated factors among Clients on Anti Retro Viral Therapy follow up in public health facilities in Debre Berhan Regio-Politian City, North Shewa, Ethiopia. Methods From July 2018 to June 2023, an institutionally based retrospective follow-up research was conducted. A total of 409 HIV-positive individuals who were enrolled in EAC were included in the study. Additionally, a straightforward random sampling method was used to choose them. Kobo Toolbox was used to collect the data, and STATA version 14.1 was used for analysis. Other variables and the extent of viral load suppression were summarized using descriptive analysis. Utilizing binary logistic regressions, the contributing components were found. Finally, every independent variable in the bivariable analysis with a p-value less than 0.25 was included in the multivariable logistic regression. Eventually, an OR with 95% CI was employed and a p-value of less than 0.05 was deemed statistically significant. Result Clients who successfully reduced their viral load were 64.3% of the participants, with a 95% confidence interval of (59.3–68.5). The likelihood of experiencing poor drug adherence (AOR 0.211, 95% CI = 0.117–0.411), being a single client (AOR 0.330, 95% CI = 0.179–0.631), living in a rural area (AOR 0.351, 95% CI = 0.202–0.601), having a history of alcohol consumption (AOR 0.531, 95% CI 0.286–0.985), and chewing khat (AOR 0.223, 95% CI = 0.09–0.545) were less likely to be significantly linked to suppressing viral load. Conclusion The target of 70% recommended by the World Health Organization was not achieved in terms of suppressing virus loads. Lower levels of viral load suppression have been associated with variables such alcohol usage, khat chewing, marital status, poor adherence, and site of residence. Thus, it is recommended that ART case managers, adherence counselors, and multidisciplinary teams at medical facilities prioritize clients with low adherence and address behavioral variables in order to optimize viral load suppression.