Factors associated with viral load suppression and indicators of stigma among people living with HIV in Dar es Salaam tertiary hospitals, Tanzania

Perception of stigma can contribute to virological failure among people living with HIV (PLHIV). This study was conducted to assess the effect of stigmatization and self-discrimination on viral load suppression among PLHIV at tertiary hospitals in Dar es Salaam, Tanzania. This was a hospital-based cross-sectional study conducted in Temeke Regional Referral Hospital (RRH) and Amana RRH at the Care and Treatment Clinic (CTC) between July and August 2020 using a structured questionnaire with open and close-ended questions. Factors for stigmatization and viral load suppression were compared using the Chi-square test, while factors for viral load suppression were analyzed using multinomial logistic regression analysis. Altogether, 406 PLHIV participated, with most female respondents, 298 (73.2%). The majority (50%) were aged between 25 and 44 years, whereas 171 (42.5%) respondents were married. Most of the participants, 382 (94.6%), were on a dolutegravir-based regimen, with the majority, 215 (52.8%), having a refilling interval of three months. The majority of the respondents, 379 (93.1%), disclosed their status. Most participants, 355 (87.4%), preferred having a separate HIV clinic, while 130 (32.1%) participants were not ready to be attended by the health care workers (HCWs) familiar to them. Male patients were 60% less likely to suppress their viral load as compared to female patients (adjusted odds ratio [aOR]: 0.4, 95% confidence interval [95%]: 0.19 - 0.77, p = 0.007). Refill interval was significantly associated with viral load suppression. For example, patients with a one-month refill interval had odds of 0.01 (95% CI: 0.003-0.42, p < 0.0001) compared to six-month refill intervals. Stigmatization elements appeared to influence the viral load suppression among PLHIV. Factors such as gender and refill time interval were significantly associated with viral load suppression among HIV patients in the Dar es Salaam region.