Correlates of viral load suppression among people living with HIV on antiretroviral treatment in Mbujimayi, Democratic Republic of Congo

Context This study was conducted in Mbujimayi to assess viral load suppression in people living with HIV (PLWH) on antiretroviral therapy (ART). The main objective was to identify the key factors influencing the success of viral suppression in terms of treatment outcomes. Methods The study involved a sample of 561 PLWH from ten healthcare facilities in the city where the viral load results were available. Data on treatment adherence, sexual behavior, viral load, and other socioeconomic and demographic factors were collected. The end point was the viral load of each PLWH. Results The median age was 49 years (IIQ: 18), the median duration of ART was 9 years (IIQ: 7), 66.31% were female, 67.56% were in clinical stage III, 67.91% used condoms, 84.31% did not have an occasional sexual partner, 91.78% did not consume alcohol, and 86.45% correctly observed ART. Multivariate analysis via binomial logistic regression predicted factors associated with viral load suppression, such as ART adherence (AOR 11.743 [95% CI: 4.153–33.204]], p < 0.001), the absence of casual sexual partners (AOR: 2.179 [95% CI: 1.221–3.888], p = 0.008), condom use (AOR: 1.764 [95% CI: 1.144–2.721], p = 0.010), and ART duration (AOR: 1.590 [1.086–2.328], p = 0.045). However, no alcohol consumption was a protective factor (AOR: 0.486 [95% CI: 0.240–0.985]). Conclusion This study highlights the importance of the objective of strict adherence to antiretroviral therapy and the stability of sexual behaviors to ensure viral suppression in PLWH. Health education and psychosocial support programs should be strengthened to encourage adherence to treatment and promote safe sexual behaviors. These findings can help guide public health policies to improve HIV treatment outcomes in the region.