Predictors of Unsuppressed HIV Viral Load and Low CD4 Count Among ZIMPHIA 2020 Survey Participants

Unsuppressed Viral load and low CD4 counts pose a significant challenge to HIV/AIDS management. Understanding the predictors of unsuppressed viral load and CD4 is critical for developing strategies to mitigate its impact. This study aimed to identify predictors of unsuppressed HIV viral load and low CD4 counts among Zimbabwe population-based HIV impact assessment survey (ZIMPHIA 2020) study participants. We analysed data from the ZIMPHIA 2020 survey. Data collection was done using structured interviews, home-based HIV testing and laboratory testing. Blood samples from participants were tested for HIV and those positive were analysed for CD4 counts and Viral load tests. We then calculated odds ratios for predictors of unsuppressed viral load (viral load ≥1000 copies/mL) and low CD4 counts (CD4< 350). The prevalence of unsuppressed viral load and low CD4 count were 20.7% and 34.7%, respectively. Males were more likely to be virally unsuppressed (25.1%) than females (18.8%) adjusted odds ratio (aOR) (95% confidence interval) 1.74 (1.43-2.11) p-value < 0.001. The odds of having a low CD4 count were higher among males (41%) than females (19%) aOR (95% confidence interval) 3.07 (2.57-3.66). Urban dwellers were more likely to have a low CD4 count (31.1%0 than rural dwellers (23.8%) aOR (95% confidence interval) 1.45 (1.21-1.73) p-value <0.001. The common predictors of both unsuppressed viral load and low CD4 were gender, never tested for HIV and never had a viral load test.