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Almost two-thirds were female (64%, n=79\u2009226). Most patients (60%, n=72\u2009430) were initiated on an efavirenz-based, tenofovir disoproxil fumarate-based and emtricitabine-based regimen (fixed-dose combination). 91% (n=76\u2009737) achieved viral suppression at least once since initiating on ART and 60% (n=57\u2009981) remained in care as at the end of February 2020. Patients from the community health centre and primary healthcare clinics were not only more likely to be virally suppressed but also more likely to be LTFU. Patients on second-line regimens were less likely to reach viral suppression (adjusted OR (aOR)=0.26, CI=0.23 to 0.28) and more likely to be LTFU (aOR=1.21, CI=1.09 to 1.35). Being older (\u226525 years) and having a recent CD4 cell count\u2265100\u2009cells\/\u00b5L were predictors of viral suppression and retention in patients on ART.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients on first-line regimens had higher VL suppression rates and were more likely to remain in care than those on a second-line regimen. Being younger and having low CD4 cell counts were associated with poor outcomes, suggesting priority groups for ART adherence support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-054019","type":"journal-article","created":{"date-parts":[[2022,4,15]],"date-time":"2022-04-15T11:30:57Z","timestamp":1650022257000},"page":"e054019","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Antiretroviral therapy uptake and predictors of virological failure in patients with HIV receiving first-line and second-line regimens in Johannesburg, South Africa: a retrospective cohort data analysis"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7870-1363","authenticated-orcid":false,"given":"Siphamandla Bonga","family":"Gumede","sequence":"first","affiliation":[{"name":"Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands"},{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Venter","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"de Wit","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemarie","family":"Wensing","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3597-1643","authenticated-orcid":false,"given":"Samanta Tresha","family":"Lalla-Edward","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,15]]},"reference":[{"key":"2025121601124666000_12.4.e054019.1","unstructured":"World Health Organization . 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