Document Type

Dissertation

Publication Date

1-1-2021

Originally Published In

ProQuest

Page Numbers

1-89

Abstract

HIV has globally infected 37.9 million people, of which 23.3 million (62%) are on antiretroviral treatment (ART). In South Africa, low rate of viral suppression among people living with HIV (PLWHIV) is a major health problem that has continued to fuel HIV persistence. A cross-sectional quantitative research design was used to investigate the relationship between treatment of comorbidities and viral suppression among HIV-infected adults aged 18 – 49 who were diabetic, had cancer, or tuberculosis (TB) in Johannesburg. The HIV care continuum formed the framework for this research. A secondary dataset from the national level survey 2017 was used for the descriptive and logistic regression analyses that were conducted. The results revealed a statistically significant association between TB treatment and viral suppression (adjusted OR=1.534, (1.053, 2.234), and p= 0.02, indicating that treatment of comorbidities such as TB has a positive impact on viral suppression outcomes. The results revealed that medical bills paid by medical aid were associated with viral suppression (OR= 1.789, (1.082, 2.957), p= 0.02. However, the model for diabetes treatment and viral suppression (OR=0.993 (0.658, 1.498), p=0.97), and the model for cancer treatment and viral suppression (OR= 1.234, (0.844, 1.805), p=0.27, revealed no significant associations. These findings indicate that concurrent, simultaneous, or integrated treatment models of comorbidities can help in achieving viral suppression. This study contributes to positive social change by highlighting the effect of the treatment of comorbidities on viral suppression in PLWHIV in an under-resourced setting, which could inform policy and influence decisions on HIV care and management.

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