Assessing the Impact of Pre-Third-Party Logistics (PRE-3PLS) and 3PLS on Viral Load Sample Turn-around Time in the Management of HIV/AIDS Patients in Ekiti State, Nigeria: A Retrospective Cross-Sectional Study

Background: In 2014, The Joint United Nations Program on HIV/AIDS and its partners launched the 90–90–90 treatment targets, which aimed to diagnose 90% of all people living with Human Immunodeficiency Virus (PLHIV), 90% of PLHIV should be on antiretroviral therapy (ART) and 90% of those on ART should achieve viral suppression by 2020. Prompt HIV viral load testing and reporting is crucial to achieving the third 90% component of the target. This study aims to assess impact of Pre-Third-Party Logistics (Pre-3PLs) and Third-Party Logistics (3PLs) on viral load sample Turn-around Time (TAT) in the management of HIV/AIDS patients in Ekiti State, Nigeria Methods: A cross-sectional study was carried out in ten health facilities. Quantitative and qualitative data were collected and analyzed using the R statistical software. Results: High load facilities had a mean TAT of 83.68 and 30.76 days for pre-3PLs and 3PLs respectively with a mean difference of 52.92 days (95% CI:18.86-86.97, p<0.05). Low load facilities had a mean TAT of 104.4 and 26.9 days for pre-3PLs and 3PLs respectively with a mean difference of 77.38 days (95% CI: 64.50-90.26, p<0.05). Other than transportation, manpower, sample quality/integrity, reagent stockout and machine downtime, proximity, and human factors were also identified as factors associated with TAT. Conclusion: The TAT reduced significantly from pre 3PLs to the present era of 3PLs. The continuous use of 3PLs should be encouraged as this could further ensure that more PLHIV will have their viral load tested with their results received on time.