title: Factors associated with HIV viral load suppression on antiretroviral therapy in Vietnam.
abstract: BACKGROUND
  Limited data are available on HIV viral suppression rates among men and women on antiretroviral therapy (ART) and factors associated with HIV RNA viral load (VL) suppression in Vietnam.
  
  
  METHODS
  We conducted a cross-sectional survey of 1255 adult patients on ART for at least 1 year across four provinces in Vietnam. Data collection included a standardised questionnaire, routine laboratory testing, and an HIV VL assay. Bivariate and logistic multivariate analyses were conducted to assess viral suppression rates and factors associated with unsuppressed HIV VL.
  
  
  RESULTS
  The median age was 34.5 years and the median time on ART was 46 months. Gender was 66% male (n=828) and 34% female (n=427). HIV viral suppression below 1000 copies/mL was 93%. Viral suppression among woman was not significantly different than among men (93.7% vs 92.9%; P=0.59). On multivariate analysis, unsuppressed HIV VL was independently associated with lower CD4 cell count, social isolation, high stigma, not receiving a single-tablet daily regimen, multiple late appointments in past year, and immunological failure.
  
  
  CONCLUSIONS
  On-treatment viral load suppression rates in Vietnam are high and already exceed the UNAIDS 90% target for viral suppression on ART. Gender does not impact viral suppression rates of patients on ART in Vietnam. Access to routine viral load testing should be improved, adherence monitoring and counselling streamlined, and ART regimens simplified to maintain viral suppression rates, as more people start ART. Psychological and social factors are also associated with unsuppressed HIV VL, necessitating treatment support interventions to address social isolation and stigma among people living with HIV in Vietnam.
authors.affiliation: FHI 360 , Ho Chi Minh City , Vietnam.
authors.forename: Suresh
authors.initials: S
authors.lastname: Rangarajan
authors.affiliation: SEARCH, Thai Red Cross AIDS Research Center, Bangkok, Thailand; Center for Applied Research on Men and Health, Ho Chi Minh City, Vietnam.
authors.forename: J Colby
authors.initials: JC
authors.lastname: Donn
authors.affiliation: Ho Chi Minh City Provincial AIDS Committee , Ho Chi Minh City , Vietnam.
authors.forename: Le Truong
authors.initials: le T
authors.lastname: Giang
authors.affiliation: Vietnam Administration for AIDS Control , Hanoi , Vietnam.
authors.forename: Duc Duong
authors.initials: DD
authors.lastname: Bui
authors.affiliation: Ho Chi Minh City Provincial AIDS Committee , Ho Chi Minh City , Vietnam.
authors.forename: Huu
authors.initials: H
authors.lastname: Hung Nguyen
authors.affiliation: FHI 360 , Ho Chi Minh City , Vietnam.
authors.forename: Plui Broh
authors.initials: PB
authors.lastname: Tou
authors.affiliation: FHI 360 , Ho Chi Minh City , Vietnam.
authors.forename: Tran Tri
authors.initials: TT
authors.lastname: Danh
authors.affiliation: FHI 360 , Ho Chi Minh City , Vietnam.
authors.forename: Ngoc Bao Chau
authors.initials: NB
authors.lastname: Tran
authors.affiliation: FHI 360 , Hanoi , Vietnam.
authors.forename: Duc Anh
authors.initials: DA
authors.lastname: Nguyen
authors.affiliation: FHI 360 , Ho Chi Minh City , Vietnam.
authors.forename: Bao Tram
authors.initials: BT
authors.lastname: Hoang Nguyen
authors.affiliation: FHI 360 , Ho Chi Minh City , Vietnam.
authors.forename: Vu Tuyet Nga
authors.initials: VT
authors.lastname: Doan
authors.affiliation: FHI 360 , Ho Chi Minh City , Vietnam.
authors.forename: Nhat Quang
authors.initials: NQ
authors.lastname: Nguyen
authors.affiliation: FHI 360 , Ho Chi Minh City , Vietnam.
authors.forename: Van Phuoc
authors.initials: VP
authors.lastname: Pham
authors.affiliation: FHI 360 , Hanoi , Vietnam.
authors.forename: Duc Giang
authors.initials: DG
authors.lastname: Dao
authors.affiliation: FHI 360 , North Carolina , United States.
authors.forename: Mario
authors.initials: M
authors.lastname: Chen
authors.affiliation: FHI 360 , North Carolina , United States.
authors.forename: Yanwu
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: Ho Chi Minh City Provincial AIDS Committee , Ho Chi Minh City , Vietnam.
authors.forename: Thi Thu Van
authors.initials: TT
authors.lastname: Tieu
authors.affiliation: An Giang Provincial AIDS Center , Long Xuyen , An Giang , Vietnam.
authors.forename: My Hanh
authors.initials: MH
authors.lastname: Tran
authors.affiliation: Quang Ninh Provincial AIDS Center , Ha Long , Vietnam.
authors.forename: Thi Hoa
authors.initials: TH
authors.lastname: Le
authors.affiliation: Dien Bien Provincial AIDS Center , Dien Bien , Vietnam.
authors.forename: Xuan Chien
authors.initials: XC
authors.lastname: Hoang
authors.affiliation: FHI 360 (retired).
authors.forename: Gary
authors.initials: G
authors.lastname: West
keywords: HIV; HIV viral load suppression; Vietnam; adherence; antiretroviral therapy; gender; single-tablet regimen