Study on the current status and influencing factors of viral load non- suppression among patients with HIV and AIDS receiving antiretroviral therapy

Introduction: According to the Chinese Guidelines for the Diagnosis and Treatment of AIDS, virological indicators are critical for evaluating the effectiveness of antiretroviral therapy (ART). This study surveyed patients with HIV/AIDS (PWHA) on ART in the Xinjiang Production and Construction Corps(XPCC) to assess non-suppressed viral load and its influencing factors. Methods Clinical data and questionnaires were collected from 4 divisions of the XPCC using convenience sampling. Logistic regression and mediation models identified factors related to non-suppressed viral load. Results Among 369 PWHA, 65 (17.62%) had non-suppressed viral load. Influencing factors included CD4 + T-cell count ≥ 500 cells/µL, treatment duration ≥ 3 years, alcohol consumption, discrimination, ART adherence, and social support (all P < 0.05). ART adherence played a full mediating role between self-efficacy, social support and viral load suppression in PWHA, with a mediation effect value (a*b) of -0.012 (95%CI: -0.552, -0.213) and − 0.026 (95%CI: -0.665, -0.389). Additionally, the "social support ⇒ medication adherence" pathway exerted a partial chain mediating role between self-efficacy and viral load suppression in PWHA, with a mediation effect value (a*b) of -0.004 (95%CI: -0.244, -0.105). Conclusions In the XPCC, PWHA's viral load suppression rate hasn't met UNAIDS' "95-95-95" target. Priority should be given to PLWH with < 3 years of treatment and CD4 + T-cell count < 500 cells/µL. HIV-related education should be delivered to patients, families and the public to enhance social support and self-efficacy, reduce HIV-related stigma, and promote healthy lifestyles (e.g., reduced alcohol consumption). These measures will improve adherence to ART, thereby achieving effective viral load suppression.