{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:01:56Z","timestamp":1792108916819,"version":"4.4.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:00:00Z","timestamp":1679011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>In Tanzania, only 66% children 0\u201314 years living with HIV know their HIV status, 66% are on treatment while 47% of children on ART are virally suppressed. Although retention on ART and poor adherence remain a challenge for children living with HIV, orphans and vulnerable children (OVC) face a greater limitation of access to and utilization of comprehensive HIV care and treatment. In response to this, the current study assessed the determinants of viral load suppression (VLS) among OVC aged 0\u201314 years living with HIV enrolled in HIV interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a cross-sectional study that used secondary data collected by the USAID Kizazi Kipya project in 81 district councils of Tanzania. Included in this study are 1,980 orphans and vulnerable children living with HIV (OVCLHIV) (0\u201314 years) enrolled and served by the project for 24 months. Data analysis involved multivariable logistic regression, with viral load suppression as the outcome of interest and HIV interventions as the main independent variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall VLS rate among the OVCLHIV was 85.3%. This rate increased from 85.3, 89.9, 97.6 to 98.8% after 6, 12, 18, and 24 months of retention on ART, respectively. Similar rates were observed as the duration of adherence to ART increased. In the multivariable analysis, OVCLHIV attending people living with HIV (PLHIV) support groups were 411 times more likely to be virally suppressed than those not attending (aOR = 411.25, 95% CI 168.2\u20131,005.4). OVCLHIV with health insurance were 6 times more likely to achieve viral suppression than those without (aOR = 6.05, 95% CI 3.28\u201311.15). OVCLHIV with &amp;gt;95% adherence to ART were 149 times more likely to be virally suppressed than those not adherent to ART (aOR = 148.96, 95% CI 42.6\u2013520.6, <jats:italic>p<\/jats:italic> &amp;lt; 0.001). Other significant factors included food security and family size. OVCLHIV reached by the different HIV community-based interventions were more likely to be virally suppressed than those who were not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>To advance viral suppression, efforts should be made to ensure that all OVCLHIV are reached by community-based interventions as well as integrating food support in HIV treatment interventions.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1076614","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T05:15:59Z","timestamp":1679030159000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Determinants of viral load suppression among orphaned and vulnerable children living with HIV on ART in Tanzania"],"prefix":"10.3389","volume":"11","author":[{"given":"Amal","family":"Ally","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amon","family":"Exavery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Charles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levina","family":"Kikoyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remmy","family":"Mseya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asheri","family":"Barankena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Fovo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akwila","family":"Temu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,17]]},"reference":[{"key":"B1","unstructured":"2021"},{"key":"B2","unstructured":"2020"},{"key":"B3","unstructured":"2016"},{"key":"B4","unstructured":"2012"},{"key":"B5","unstructured":"Tanzania HIV Impact Survey (THIS) 2016-2017: Final Report. Dar es Salaam, Tanzania2018"},{"key":"B6","unstructured":"2019"},{"key":"B7","unstructured":"2017"},{"key":"B8","unstructured":"2019"},{"key":"B9","unstructured":"Adolescent HIV in Tanzania: Factors Affecting Viral Load Suppression the Transition to Adult Care\n            SinaiI\n            BowskyS\n            CantelmoC\n            Mbuya-BrownR\n            PanjshiriY\n            BalampamaM\n          Palladium, Health Policy PlusWashington, DC2019"},{"key":"B10","doi-asserted-by":"publisher","first-page":"bpac002","DOI":"10.1093\/biomethods\/bpac002","article-title":"Effectiveness of a community-based intervention (Konga model) to address the factors contributing to viral load suppression among children living with HIV in Tanzania: a cluster-randomized clinical trial protocol","volume":"7","author":"Kihulya","year":"2022","journal-title":"Biol Methods Protoc"},{"key":"B11","doi-asserted-by":"publisher","first-page":"11001","DOI":"10.7189\/jogh.11.11001","article-title":"Evidence on the effectiveness of community-based primary health care in improving HIV\/AIDS outcomes for mothers and children in low- and middle-income countries: findings from a systematic review","volume":"11","author":"Mushamiri","year":"2021","journal-title":"JOGH."},{"key":"B12","unstructured":"2017"},{"key":"B13","unstructured":"2019"},{"key":"B14","unstructured":"2021"},{"key":"B15","unstructured":"2019"},{"key":"B16","unstructured":"2015"},{"key":"B17","unstructured":"2902015"},{"key":"B18","doi-asserted-by":"publisher","first-page":"12","DOI":"10.11613\/BM.2014.003","article-title":"Understanding logistic regression analysis","volume":"24","author":"Sperandei","year":"2014","journal-title":"Biochem Medica."},{"key":"B19","doi-asserted-by":"publisher","first-page":"154","DOI":"10.4040\/jkan.2013.43.2.154","article-title":"An introduction to logistic regression: from basic concepts to interpretation with particular attention to nursing domain","volume":"43","author":"Park","year":"2013","journal-title":"J Korean Acad Nurs."},{"key":"B20","unstructured":"2018"},{"key":"B21","unstructured":""},{"key":"B22","doi-asserted-by":"publisher","first-page":"567","DOI":"10.36959\/695\/567","article-title":"Virological suppression among HIV infected adolescents and youths receiving ART in the national teaching and referral hospital in Kenya","volume":"4","author":"Kangethe","year":"2020","journal-title":"Clin J HIV AIDS"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e111948","DOI":"10.1371\/journal.pone.0111948","article-title":"Safety and effectiveness of combination antiretroviral therapy during the first year of treatment in HIV-1 infected Rwandan children: a prospective study","volume":"9","author":"Mutwa","year":"2014","journal-title":"PLoS ONE."},{"key":"B24","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/1742-6405-10-25","article-title":"Incidence and risk factors for first line anti retroviral treatment failure among Ugandan children attending an urban HIV clinic","volume":"10","author":"Sebunya","year":"2013","journal-title":"AIDS Res Ther."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e0190260","DOI":"10.1371\/journal.pone.0190260","article-title":"Higher retention and viral suppression with adolescent-focused HIV clinic in South Africa","volume":"12","author":"Zanoni","year":"2017","journal-title":"PLoS ONE."},{"key":"B26","unstructured":"2018"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e10340","DOI":"10.1371\/journal.pone.0010340","article-title":"Food insecurity as a barrier to sustained antiretroviral therapy adherence in Uganda","volume":"5","author":"Weiser","year":"2010","journal-title":"PLoS ONE."},{"key":"B28","doi-asserted-by":"publisher","first-page":"e85327","DOI":"10.1371\/journal.pone.0085327","article-title":"Food insecurity is associated with increased risk of non-adherence to antiretroviral therapy among HIV-infected adults in the Democratic Republic of Congo: a cross-sectional study","volume":"9","author":"Musumari","year":"2014","journal-title":"PLoS ONE."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1076614\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T05:16:22Z","timestamp":1679030182000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1076614\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,17]]},"references-count":28,"alternative-id":["10.3389\/fpubh.2023.1076614"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1076614","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,17]]},"article-number":"1076614"}}