Viral failure and associated factors in adults on second line antiretroviral therapy in public hospitals of Harari Region and Dire Dawa administration, Eastern Ethiopia

Nearly 1 in 10 adults on second-line ART experienced virological failure. Factors such as smoking, nutritional status, TB-HIV co-infection, and adherence counseling significantly influenced outcomes. Continuous monitoring and clinical interventions are crucial to reduce virological failures in this population.