{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T18:12:17Z","timestamp":1778177537231,"version":"3.51.4"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>High viral load indicates poor treatment outcomes among people living with HIV (PLHIV) on antiretroviral therapy (ART). However, there is a dearth of evidence on specific factors associated with high viral load in resource-limited settings, including Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this study is to identify factors contributing to high viral load among PLHIV aged 15 years and older on ART for at least six months in Tanga, Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is\u00a0analytical cross-sectional study of 233 PLHIV attending the Care and Treatment Centre (CTC) in Tanga region from September to November 2023. A systematic sampling method was used to select participants for face-to-face interviews. A structured questionnaire was used to collect socio-demographic information while clinical data were collected from the patients\u2019 records and CTC database. Descriptive analysis was used to estimate the prevalence of high viral load, while Pearson Chi-square tests compared categorical variables, and the logistic regression assessed determinants of high viral load.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>High viral load was prevalent among 35.2% [95% CI: 29.3%\u221241.6%] PLHIV attending CTC in Tanga region. Higher viral load was noted among younger adults (52.5%), those in sales\/services (63.6%), professionals (54.5%), and unskilled workers (53.2%) compared to their counterparts. PLHIV with severe food insecurity were more likely to exhibit higher viral load compared to those from food secure households (AOR\u2009=\u20099.6; 95% CI: 2.6\u201335.2). Those consuming alcohol were 4.2 times more likely to have a higher viral load compared to non-drinkers (AOR\u2009=\u20094.2; 95% CI: 1.4\u201312.5). PLHIV aged 20\u201324 were 5.4 times more likely to exhibit elevated viral load levels compared to their older counterparts (AOR\u2009=\u20095.4; 95% CI: 1.8\u201315.7). Additionally, PLHIV in sales and services occupations were 6.1 times more likely to have a higher viral load compared to those in agriculture (AOR\u2009=\u20096.1; 95% CI: 1.1\u201335 and those facing high stigma were 4.3 times more likely to have a higher HVL than individuals with good social support and low stigma (AOR\u2009=\u20094.3, 95% CI: 1.0\u201318.7, p\u2009=\u20090.049).).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>More than one in three adult PLHIV on ART in Tanga Tanzania had a high viral load. This burden highlights a steep climb to reach the last 95 target ahead of the deadline. Efforts should focus on young adults, those with households\u2019 food insecurity, consuming alcohol, and with perceived stigma in Tanzania and areas with similar context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0348862","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T17:27:36Z","timestamp":1778174856000},"page":"e0348862","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with high viral load among HIV clients aged 15 years and older receiving treatment in Tanga city council, Tanzania: A facility-based cross-sectional study"],"prefix":"10.1371","volume":"21","author":[{"given":"Aqbara Ibrahim","family":"Chande","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7137-0058","authenticated-orcid":true,"given":"Novatus A.","family":"Tesha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Sunguya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"issue":"1","key":"pone.0348862.ref001","doi-asserted-by":"crossref","first-page":"20917","DOI":"10.7448\/IAS.19.1.20917","article-title":"The 90 90 90 strategy to end the HIV Pandemic by 2030: Can the supply chain handle it?","volume":"19","author":"D Jamieson","year":"2016","journal-title":"J Int AIDS Soc"},{"key":"pone.0348862.ref002","unstructured":"UNAIDS data 2018. https:\/\/www.unaids.org\/en\/resources\/documents\/2018\/unaids-data-2018 2023 March 22."},{"key":"pone.0348862.ref003","article-title":"Packaged interventions for people presenting with advanced HIV disease: A systematic review","author":"C Migone","year":"2017"},{"issue":"2","key":"pone.0348862.ref004","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0191944","article-title":"Inpatient mortality rates during an era of increased access to HIV testing and ART: A prospective observational study in Lilongwe, Malawi","volume":"13","author":"MM Matoga","year":"2018","journal-title":"PLoS One"},{"key":"pone.0348862.ref005"},{"key":"pone.0348862.ref006","author":"NACP-National AIDS Control Programme"},{"issue":"4","key":"pone.0348862.ref007","article-title":"Near point-of-care HIV viral load testing: Cascade after high viral load in suburban Yangon, Myanmar","volume":"18","author":"NN Tun","year":"2023","journal-title":"PLoS One"},{"key":"pone.0348862.ref008","unstructured":"National Bureau of Statistics. 2022 Population and Housing Census - Preliminary Report in Swahili Language. https:\/\/www.nbs.go.tz\/index.php\/en\/census-surveys\/population-and-housing-census\/802-matokeo-ya-mwanzo-ya-sensa-ya-watu-na-makazi-ya-mwaka-2022"},{"key":"pone.0348862.ref009","unstructured":"UNAIDS. 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