Factors associated with viral Load re-suppression after enhanced adherence counseling among recipients of care with an Initial high viral load result in RISE-supported facilities in five States in Nigeria

This study explores factors influencing viral re-suppression among 1,607 recipients of HIV care in Nigeria who completed Enhanced Adherence Counseling (EAC) between July 2021 and June 2022. The analysis, part of the Reaching Impact, Saturation, and Epidemic Control (RISE) project, utilized routine program data from 132 health facilities. Results showed a 91% re-suppression rate post-EAC, with age and ART regimen type identified as significant factors. Adolescents (10-19 years) had a higher likelihood of re-suppression, while ROC on second-line regimens exhibited lower resuppression rates. These findings inform programmatic decisions to enhance HIV treatment outcomes in Nigeria. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This paper is based on work supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through United States Agency for International Development (USAID) under the terms of cooperative agreement 7200AA19CA00003 of the Reaching Impact, Saturation, and Epidemic (RISE) project managed by Jhpiego and other partners. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This analysis falls under the non-research determination provided by Johns Hopkins School of Public Health Institutional Review Board IRB#24824 "Secondary Data Analysis of HIV Prevention, Care and Treatment Service Delivery Programs in Africa,". I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request. This analysis was carried out using data from Reaching Impact, Saturation, and Epidemic (RISE) Control program funded by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID)