HIV Viral Load Suppression and Associated Factors Among PLHIV with Non-Communicable Diseases in Uganda’s Teso Region: A Cross-sectional Retrospective Study

Background: As Uganda scales up integrated chronic care, understanding viral load suppression (VLS) among people living with HIV (PLHIV) with non-communicable diseases (NCDs) is critical for optimizing service delivery. This study thus determined VLS among the PLHIV with NCDs and associated factors. Methods: We conducted a cross-sectional analysis using routine program data from 10 districts in Eastern Uganda. Categorical variables reported as frequencies and percentages, while continuous as mean and standard deviation. Robust Poisson regression estimated crude and adjusted prevalence ratios (aPRs) for VLS, controlling for NCD status, age, sex, and facility level using 95% confidence interval (CI) and p < 0.05 for statistical significance. A forest plot visualized effect sizes and confidence intervals. STATA Corp version 15 was used for the analysis. Results: Among 8,306 PLHIV, 62.4% were female, with a mean (Standard Deviation) age of 46.7 years (13.8). Overall VLS was 94.7%. NCD comorbidity was 8.45%, predominantly hypertension (7%). Crude analysis showed higher VLS among PLHIV with NCDs (PR = 1.023; p  = 0.002), but adjusted estimates attenuated (aPR = 1.015; 95% CI: 0.999–1.031; p  = 0.065). Older age groups (30–39, 40–49, 50+) had significantly higher VLS than those under 30 ( aPR = 1.063; 95% CI: 1.034–1.091; p  < 0.001), (aPR = 1.073; 95% CI: 1.044–1.102; p  < 0.001), (aPR = 1.071; 95% CI: 1.043–1.100; p  < 0.001) respectively. Males had lower VLS than females (aPR = 0.978, 95% CI [0.968, 0.989] p  < 0.001). Clients at Health Centre III had reduced VLS (aPR = 0.979 95%CI [0.961, 0.997]; p  = 0.023), while Health Centre IV and hospitals showed no significant difference when compared with those in the special clinic. Conclusion: VLS among PLHIV with NCDs was comparable to those without, suggesting integrated care may mitigate disparities. However, age, sex, and facility level remain key determinants. Targeted interventions are needed for younger clients, men, and health centre IIIs to sustain viral suppression.