{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T12:11:26Z","timestamp":1783167086881,"version":"3.54.6"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,1,29]],"date-time":"2022-01-29T00:00:00Z","timestamp":1643414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["W81XWH-11-2-0174"],"award-info":[{"award-number":["W81XWH-11-2-0174"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32AI114398"],"award-info":[{"award-number":["T32AI114398"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Children and adolescents living with HIV (CALHIV) face unique challenges, including poorer treatment outcomes, risk for drug-resistance mutations (HIVDRMs), and limited drug formulations. We estimated viral suppression (VS) prevalence and evaluated predictors of VS and HIVDRMs in Kenya.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>From 2018\u20132020, CALHIV 1\u201319 years on antiretroviral therapy (ART) &amp;gt;6 months were enrolled in this cross-sectional study. Participants underwent viral load (VL) testing; those with VL \u22651000 copies\/mL had HIVDRM testing. Sociodemographic questionnaires and medical record abstraction were completed. VS prevalence (VL &amp;lt;1000 copies\/mL) was estimated; robust Poisson regression models were used to estimate prevalence ratios (PRs) and 95% CIs for associations between potential predictors of VS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Nine hundred and sixty-nine participants were enrolled. VS prevalence was .80 (95% CI: .78\u2013.83). Being on ART &amp;gt;24 months (adjusted PR [aPR]: 1.22; 95% CI: 1.06\u20131.41), an integrase strand transfer inhibitor\u2013containing regimen (1.13; 1.02\u20131.26), and attending a level 3 health facility (1.23; 1.11\u20131.36) were associated with VS. Missing \u22653 doses of ART in the past month (aPR: .73; 95% CI: .58\u2013.92), having a viremic mother with HIV (.72; .53\u2013.98), and having 3\u20137 (.90; .83\u2013.97), 8\u201313 (.89; .82\u2013.97), or \u226514 (.84; .77\u2013.92) compared with &amp;lt;2 adherence counseling referrals were inversely associated with VS. A high proportion (n\u2005=\u2005119, 81.5%) of unsuppressed participants had evidence of any major HIVDRM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>HIV treatment programs should target interventions for pediatric patients at risk for treatment failure\u2014namely, those with a caregiver with failed VS and those struggling with adherence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac059","type":"journal-article","created":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T12:13:46Z","timestamp":1643285626000},"page":"936-944","source":"Crossref","is-referenced-by-count":15,"title":["Prevalence and Correlates of Viral Load Suppression and Human Immunodeficiency Virus (HIV) Drug Resistance Among Children and Adolescents in South Rift Valley and Kisumu, Kenya"],"prefix":"10.1093","volume":"75","author":[{"given":"Isaac","family":"Tsikhutsu","sequence":"first","affiliation":[{"name":"US Army Medical Research Directorate\u2013Africa , Nairobi , Kenya"},{"name":"HJF Medical Research International , Kericho , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Bii","sequence":"additional","affiliation":[{"name":"US Army Medical Research Directorate\u2013Africa , Nairobi , Kenya"},{"name":"HJF Medical Research International , Kericho , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8026-9901","authenticated-orcid":false,"given":"Nicole","family":"Dear","sequence":"additional","affiliation":[{"name":"US Military HIV Research Program, Walter Reed Army Institute of Research , Silver Spring, Maryland , USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavitha","family":"Ganesan","sequence":"additional","affiliation":[{"name":"US Military HIV Research Program, Walter Reed Army Institute of Research , Silver Spring, Maryland , USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Kasembeli","sequence":"additional","affiliation":[{"name":"US Army Medical Research Directorate\u2013Africa , Nairobi , Kenya"},{"name":"HJF Medical Research International , Kericho , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentine","family":"Sing\u2019oei","sequence":"additional","affiliation":[{"name":"US Army Medical Research Directorate\u2013Africa , Nairobi , Kenya"},{"name":"HJF Medical Research International , Kisumu , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Rombosia","sequence":"additional","affiliation":[{"name":"Ministry of Health, Kisumu County , Kisumu , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Ochieng","sequence":"additional","affiliation":[{"name":"US Army Medical Research Directorate\u2013Africa , Nairobi , Kenya"},{"name":"HJF Medical Research International , Kericho , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Desai","sequence":"additional","affiliation":[{"name":"US Military HIV Research Program, Walter Reed Army Institute of Research , Silver Spring, Maryland , USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Wolfman","sequence":"additional","affiliation":[{"name":"US Military HIV Research Program, Walter Reed Army Institute of Research , Silver Spring, Maryland , USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Coakley","sequence":"additional","affiliation":[{"name":"US Military HIV Research Program, Walter Reed Army Institute of Research , Silver Spring, Maryland , USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth H","family":"Lee","sequence":"additional","affiliation":[{"name":"US Military HIV Research Program, Walter Reed Army Institute of Research , Silver Spring, Maryland , USA"},{"name":"The Uniformed Services University of the Health Sciences , Bethesda, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick W","family":"Hickey","sequence":"additional","affiliation":[{"name":"The Uniformed Services University of the Health Sciences , Bethesda, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Livezey","sequence":"additional","affiliation":[{"name":"The Uniformed Services University of the Health Sciences , Bethesda, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Agaba","sequence":"additional","affiliation":[{"name":"US Military HIV Research Program, Walter Reed Army Institute of Research , Silver Spring, Maryland , USA"},{"name":"Henry M. 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