Predictors of Viral Load Non-Suppression Among People Living With HIV in Gurage Zone, Southern Ethiopia: An Institutional-Based Cross-Sectional Study

Despite the expansion of antiretroviral therapy (ART) in Ethiopia, achieving consistent viral suppression remains a significant challenge in regional clinical settings. In the Gurage Zone of Southern Ethiopia, a substantial proportion of patients fail to reach undetectable viral levels, yet the specific clinical and geographic factors driving this non-suppression are not fully understood. The main objective of this study was to identify the determinants of HIV and AIDS viral load measurement in Gurage Zone, Southern Ethiopia. An institutional-based cross-sectional study was conducted using secondary data extracted from the medical records of 466 HIV-positive patients at Butajira and Atat Hospitals. The study population included individuals initiated on ART who were followed between August 2016 and July 2019. Data were collected using a structured extraction tool and analyzed using SPSS version 20. The analysis employed descriptive statistics (frequencies, percentages, mean, and standard deviation) to summarize the data, while inferential statistics, including Chi-square tests and binary logistic regression at a 5% significance level were used to identify predictors of viral load status. Out of 466 patient records, two-thirds (66.7%) achieved viral suppression, while 33.3% maintained detectable viral loads. Multivariable binary logistic regression identified that being unscreened for Tuberculosis (TB), poor medication adherence, and rural residence were the strongest predictors of non-suppression. Additionally, baseline CD4 count, body weight, and ART regimen significantly influenced treatment success. These findings underscore a critical need for HIV programs in the Gurage Zone to prioritize integrated TB screening, ensure optimal medication adherence, and provide tailored nutritional and immune support. Furthermore, strategically selecting ART regimens and implementing targeted interventions for rural populations are essential steps to bridge the current gap in viral suppression rates and improve overall health outcomes in the region.