Background In 2016, Nigeria transitioned to ‘Test & Treat’, a policy where all people living with HIV (PLHIV) are treated with lifelong antiretroviral therapy (ART). There are unique challenges achieving viral suppression in ALHIV mainly due to increased stigma & lack of social support. Hypothesis tested was ART adherence effect on viral load outcome. We examined viral suppression among adolescents living with HIV in Western Nigeria.

Methods This study was an observational prospective cohort study of adolescents living with HIV (ALHIV) already initiated on antiretroviral therapy for at least six months, enrolled in health facilities across supported facilities in Western Nigeria, during a 12-month observation period starting October 2016 till September 2017. Quantitative viral load analysis was done using Polymerase Chain Reaction, Roche Cobas Taqman 96 Analyzer.

Results A total of 126 (64 males & 62 females) subjects were recruited. The mean age of 13.58 ± 4.26 years. 83 (65.9%) & 71 (56.3%) had viral suppression of <1000 & <50 RNA copies per ml respectively. The 43 subjects went through peer counseling by trained ALHIV and enhanced adherence counseling (EAC) for three months and viral load test repeated three further months after, which made 113 (89.7%) & 101 (80.1%) of the subjects have <1000 RNA & <50 RNA copies per ml respectively during the observation. The ALHIVs joined the institutionalized social-media driven support group & adolescent decentralized care model ensuring they achieve the third 90 at an undetectable level. ART adherence has significant effect on viral load outcome (χ² = 6.42, df = 1, P = 0.001).

Conclusion ART adherence counseling is key to the achieving viral suppression and determine infection prognosis, thus, developing robust continuous quality improvement (CQI) plans to address issues across the cascade ultimately helping in the monitoring of HIV/AIDS disease progression and decrease treatment failure tendencies.

Disclosure No significant relationships.