Correlates of Viral Suppression in Adolescents With HIV Taking Antiretroviral Therapy in Mozambique: Results of a Multicenter Cross-Sectional Survey

PURPOSE: Adolescents living with HIV (ALHIV) have poorer outcomes on antiretroviral therapy (ART) than adults. We assessed correlates of viral suppression (VS) among ALHIV, aged 15-19 years, in Mozambique. METHODS: This is a nested analysis within the CombinADO trial (NCT04930367), a cluster randomized trial assessing the effectiveness of a multilevel health services intervention to improve VS (HIV RNA <50 copies/mL) among ALHIV. After 12 months of intervention implementation, ALHIV at 12 health facilities were approached for enrolment into a postintervention assessment that included surveys and a blood draw for viral load (VL) measurement. Multivariable logistic regression reporting adjusted odds ratios (aORs) was used to quantify the association of different factors with VS. Data were collected between November 2022 and July 2023. RESULTS: Of 544 ALHIV 15-19 years (72% female) included in this analysis, 300 (55%) had VS. ALHIV who understood their latest VL result were more likely to have VS (aOR = 1.59, 95% confidence interval [CI] 1.05-2.42). VS was lower among ALHIV who had moderate and high levels of internalized stigma (aOR = .45, 95% CI .21-.96 and aOR = 0.38, 95% CI .17-.88, respectively). DISCUSSION: Reducing internalized stigma and improving understanding of VL results may contribute to improving VS among ALHIV in Mozambique. These findings underscore the urgent need for adolescent tailored HIV care in Mozambique.