Association of Antiretroviral Drug Regimen With Viral Suppression in HIV-positive Children on Antiretroviral Therapy in Eswatini

Overview

This paper presents enrollment results from our United States Agency for International Development-funded Project SOAR study entitled “Effect of family-centered model of HIV care (FAM-CARE) on viral suppression and retention in care of HIV-positive children in Swaziland”. The results of this paper have significant implications for the quality of care that is provided to HIV-positive children and our ability to achieve the third “95” of our treatment goals.  The median age of the 377 enrolled children was 8.7 years with median ages at HIV diagnosis of 2.1 years and ART initiation of 2.6 years. This study found that while all but one of the HIV-positive children were receiving ART, only 77.9% were virally suppressed (only 73.5% were undetectable).  One quarter of the children were receiving EFV based regimens, one third were receiving Kaletra based regimens and the remainder (43%) were on NVP based regimens.  The only factor associated with lack of suppression was the ART regimen that the child was receiving with 72.1% suppression for children on NVP containing regimens compared with 86.7% with children on EFV based regimens.    Also important for our programming is that almost 20% of children aged 11-15 years were not aware of their HIV status and over half of the HIV-positive caregivers of these children did not have any viral load recorded.