Document Type
Capstone Experience
Graduation Date
8-2025
Degree Name
Master of Public Health
Department
Epidemiology
First Committee Member
Dr. Brittney Dickey
Second Committee Member
Dr. Nicole Kolm-Valdivia
Third Committee Member
Dr. Julie Petersen
Fourth Committee Member
Dr. Marouf Balde
Abstract
Background: Viral suppression among children living with HIV (CLHIV) remains suboptimal in Côte d’Ivoire. This study assessed clinical, socioeconomic, and demographic characteristics associated with viral non-suppression among CLHIV aged 2–14 years in Abidjan 2 to inform targeted interventions under the U.S. Agency for International Development (USAID)-supported Reaching Impact, Saturation, and Epidemic Control (RISE) project.
Methods: A retrospective analysis was conducted using routine program data from 1,203 CLHIV across 73 health facilities. Descriptive, bivariate, and multivariate analyses were performed to examine associations with viral load suppression status. Findings guided the development of a multi-level implementation plan using Kotter’s Change Management Framework, the Socio-Ecological Model, and Transformational Leadership Theory.
Results: Of 1,203 CLHIV, 513 had documented VL results, and 14.4% were non-suppressed. Missingness was substantial for key variables, including HIV disclosure (71%) and parental HIV status (74%). In multivariate modeling, older age (10–14 years) was significantly associated with non-suppression (adjusted prevalence ratio = 2.47; 95% CI, 1.05–5.82). Other factors, including parental HIV status, ART regimen, pill burden, and Orphans and Vulnerable Children program enrollment, were not statistically significant but revealed data quality and structural service gaps.
Conclusion: Pediatric VL suppression in Abidjan 2 is compromised by both clinical and structural barriers. Strategies should focus on improving documentation, supporting age-appropriate disclosure, and implementing tailored adherence interventions. Recommendations are based on both literature and direct program experience, with future research needed to address unmeasured factors such as caregiver occupation, income level, and distance to health facilities.
Recommended Citation
Kamagate, Maman Fathim, "Analysis of the Clinical, Socioeconomic, and Sociodemographic Characteristics of Virally Unsuppressed Children Aged 2-14 Living with HIV/AIDS in the Region of Abidjan 2 – Côte d’Ivoire (Region Supported by USAID)" (2025). Capstone Experience: Master of Public Health. 407.
https://digitalcommons.unmc.edu/coph_slce/407