Abstract
Introduction: Achieving viral load suppression among the adolescents living with HIV continues to hold back attainment of sustainable development goals. TASO Mbale realized a viral load suppression rate of 63.1% among the adolescents living with HIV in care in quarter 4 of 2016. We therefore, instituted a quality imrpovement project to improve Viral load suppression from 63.1% in quarter 4 2016 to 90% by the end of quarter 4 2017. Method: Baseline data from the Uganda viral load dashboard were analyzed, and fishbone diagram was utilized to provide root causes of low viral load suppression among the adolescents living with HIV at TASO Mbale. The identified barriers were Knowlegde gap, among the adolescents, on positive living, Missing clinic appointments, Sub-optimal adherence, Poorly planned adolescent HIV clinic, Inadequate follow-up and Low use of data for informed decisions. A plan-do-study-act (PDSA) model was applied to implement tested changes. Strategies that worked included introduction of appointment register to track appointment behaviour of the adolescents, generating lists of clients on appointment who were due for Viral Load bleeding, telephone calls for follow up, increasing the frequency of reviewing adolescents from once a month to twice a week, committing a dedicated team responsible for adolescent care. Results: The viral load suppression improved from 63.1% in quarter 4 of 2016 to 63.8% in the first quarter of 2017, to 87.5% in quarter 2 of 2017, 97.6% in the third quarter and 91.4% in quarter 4 of 2017. Conclusion: The use of quality improvement in addressing gaps in HIV service delivery is highly effective.
Highlights
Achieving viral load suppression among the adolescents living with Human Immune Deficiency Virus (HIV) continues to hold back attainment of sustainable development goals
Non-viral load (VL) suppression is associated with poor clinical outcomes and could explain why AIDS related deaths have not improved among the ALHIV especially in sub-Saharan Africa [8] and yet AIDS related mortality has reduced by almost 50% in the last 15 years in the general population [9]
We found that the VL suppression (VLS) rate among the ALHIV at The AIDS Support Organization (TASO) Mbale was 63.1% in quarter four of 2016
Summary
Achieving viral load suppression among the adolescents living with HIV continues to hold back attainment of sustainable development goals. In order to achieve this ambitious target, the global community has embarked on promoting universal health coverage such as early provision of antiretroviral treatment (ART) across all populations including adolescents aged 10 - 19 years living with HIV (ALHIV), irrespective of clinical or immunological status [3]. This recommendation has been adopted by several countries including Uganda, many studies have reported lower rates of ART adherence and viral load (VL) suppression among the ALHIV [3] [4] [5] [6] [7] than other subpopulations. Non-VL suppression is associated with poor clinical outcomes and could explain why AIDS related deaths have not improved among the ALHIV especially in sub-Saharan Africa [8] and yet AIDS related mortality has reduced by almost 50% in the last 15 years in the general population [9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
