Assessing Attrition and Viral Load Suppression Among Patients Receiving Antiretroviral Therapy at Somanya Polyclinic in the Yilo Krobo Municipality of the Eastern Region of Ghana

Abstract

Background: Attrition from clinical care undermines efforts to achieve sustained viral load suppression and epidemic control within ART programmes. Retention in care and viral suppression among people living with HIV (PLHIV) are critical for achieving global targets to end the HIV epidemic by 2030. Aim: This study assessed attrition and viral load suppression among patients receiving ART at Somanya Polyclinic, Yilo Krobo Municipality, Eastern Region of Ghana, from 2021 to 2024. Methods: A retrospective cohort design used secondary data from the National AIDS/STI Control Programme (NACP). Routine data on PLHIV aged 10 years and above enrolled at Somanya Polyclinic between January 2021 and December 2024 were extracted from the Electronic Tracker database, cleaned in Excel, and analysed in STATA 18. Descriptive statistics, chi-square tests, survival analysis, and multivariable logistic regression examined factors associated with attrition and viral suppression at 5% significance. Results: Of 566 patients, 162 (28.62%) were retained in care while 404 (71.38%) experienced attrition. Among those retained, 120 had documented viral load results, of whom 88 (73.33%) achieved suppression. Occupation was significantly associated with attrition; compared to employed individuals, traders/business persons (AOR = 1.88; p = 0.021) and the unemployed (AOR = 5.27; p = 0.004) had higher odds of attrition. For viral load non-suppression, previously married (AOR = 3.98; p = 0.035) and single individuals (AOR = 4.85; p = 0.009), and students (AOR = 17.89; p = 0.013), had higher odds than married/cohabiting individuals. Conclusion: Retention in care was low, with substantial attrition, and a notable proportion of tested patients remained unsuppressed. Findings highlight the need for targeted interventions for economically vulnerable groups, additional support for patients outside stable marital relationships, and strengthened routine viral load monitoring.