ArticlePloS one2020
Routine viral load monitoring and enhanced adherence counselling at a public ART centre in Mumbai, India.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Simulation modeling for the design and evaluation of HIV drug resistance interventions: a systematic review of literature.BMC public health · 2026Pooled it
- Viral load suppression after enhanced adherence counseling among HIV patients on antiretroviral therapy (2019-2024): a systematic review and meta-analysis in East Africa.AIDS research and therapy · 2025Pooled it
- Article
- Examining and classifying reasons for missing viral loads among adults living with HIV: An extended outcome investigation and ascertainment approach in Western Kenya.PLOS global public health · 2025Article
- Conceptual framework for the health and well-being of caregivers of HIV/AIDS orphans in North West Province, South Africa.BMC nursing · 2024Article
- Adherence of healthcare providers to Enhanced Adherence Counseling (EAC) intervention protocol in West Amhara Public Health Facilities, Northwest Ethiopia, 2023: mixed method evaluation.BMC infectious diseases · 2024Article
- Article
- Time to Treatment Failure and Its Predictors Among Second-Line ART Clients in Amhara Region, Ethiopia: A Retrospective Follow-Up Study.HIV/AIDS (Auckland, N.Z.) · 2024Article
- Experiences of support by unsuppressed adolescents living with HIV and their caregivers in Windhoek, Namibia: a qualitative study.Frontiers in public health · 2024Article
- Article
- Factors associated with viral load re-suppression after enhanced adherence counseling among people living with HIV with an initial high viral load result in selected Nigerian states.PLOS global public health · 2024Article
- Reaching Viral Suppression Among People With HIV With Suspected Treatment Failure who Received Enhanced Adherence Counseling in Southern Nigeria: A Retrospective Analysis.Open forum infectious diseases · 2022Article
- Barriers and facilitators to the utilization of the intensive adherence counselling framework by healthcare providers in Uganda: a qualitative study.BMC health services research · 2022Article
- Virological failure and treatment switch after ART initiation among people living with HIV with and without routine viral load monitoring in Asia.Journal of the International AIDS Society · 2022Article
- Virological outcomes and risk factors for non-suppression for routine and repeat viral load testing after enhanced adherence counselling during viral load testing scale-up in Zimbabwe: analytic cross-sectional study using laboratory data from 2014 to 2018.AIDS research and therapy · 2022Article
- Magnitude of Viral Load Suppression and Associated Factors among Clients on Antiretroviral Therapy in Public Hospitals of Hawassa City Administration, Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2022Article
- Impact of Motivational Enhanced Adherence Counseling and Point-of-Care Viral Load Monitoring on Viral Load Outcome in Women on Life-Long ART: A Randomized Pilot Study.AIDS research and treatment · 2022Article
- Viral Load Monitoring Practices and Correlates of Viral Non-suppression Among Children and Young Adolescents Living With HIV in Kiambu County, Kenya.Sage open pediatricsArticle
- Implementation of a Psychosocial Support Intervention for Adolescents on Antiretroviral Treatment: Challenges and Experiences from Ehlanzeni District, South Africa.Journal of the International Association of Providers of AIDS CareArticle
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Authors and funding
14 authors.
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Abstract
backgroundRoutine viral-load (VL) measurements along with enhanced adherence counselling (EAC) are recommended to achieve virological suppression among people living with HIV/AIDS (PLHA) on anti-retroviral therapy (ART). The Mumbai Districts AIDS Control Society along with Médecins Sans Frontières has provided routine VL measurements and EAC to PLHA on ART at King Edward Memorial (KEM) hospital, Mumbai since October-2016. This study aims to describe the initial VL results and impact of EAC on viral suppression and factors associated with initial viral non-suppression among patients with an initial detectable VL, in a cohort of patients tested between October-2016 and September-2018.
methodsThis is a descriptive study of PLHA on ART who received VL testing and EAC during October-2016 to September-2018. Log-binomial regression was used to identify factors associated with a high VL.
resultsAmong 3849 PLHA who underwent VL testing, 1603(42%) were female and median age was 42 years (IQR:35-48). Majority were referred for routine testing (3432(89%)) and clinical/immunological failure (233(6%)). Overall, 3402(88%) PLHA had suppressed VL at initial testing. Among 3432 tested for routine monitoring, 3141(92%) had VL suppressed. Of 291 with VL>1000c/ml, 253(87%) received EAC and after repeat VL, 70(28%) had VL<1000c/ml. Among 233 referred for clinical/immunological failure, 122(52%) had VL>1000c/ml and 109 have been switched to second-line ART. CD4 count<500 (aOR-5.0[95%CI 3.8-6.5]), on ART for<5 years (aOR-1.5[1.1-2.0]) and age<15 years (aOR-5.2[3.0-8.9]) were associated with an initial VL>1000c/ml. Factors associated with follow-up VL suppression included EAC (p<0.05) and being on second-line ART (p<0.05).
conclusionResults from a routine VL program in public sector in India were encouraging and in line with UNAIDS 90-90-90 targets. Routine VL monitoring along with EAC resulted in early switch to alternative optimised regimens while also preventing unnecessary switches. Along with the vital scale up of routine VL monitoring, implementation of enhanced adherence strategies for patients with detectable viral load should be ensured.
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