Study on the current status and influencing factors of viral load non- suppression among patients with HIV and AIDS receiving antiretroviral therapy

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This study surveyed patients with HIV/AIDS (PWHA) on ART in the Xinjiang Production and Construction Corps(XPCC) to assess non-suppressed viral load and its influencing factors. Methods Clinical data and questionnaires were collected from 4 divisions of the XPCC using convenience sampling. Logistic regression and mediation models identified factors related to non-suppressed viral load. Results Among 369 PWHA, 65 (17.62%) had non-suppressed viral load. Influencing factors included CD4 + T-cell count ≥ 500 cells/µL, treatment duration ≥ 3 years, alcohol consumption, discrimination, ART adherence, and social support (all P < 0.05). ART adherence played a full mediating role between self-efficacy, social support and viral load suppression in PWHA, with a mediation effect value (a*b) of -0.012 (95%CI: -0.552, -0.213) and − 0.026 (95%CI: -0.665, -0.389). Additionally, the "social support ⇒ medication adherence" pathway exerted a partial chain mediating role between self-efficacy and viral load suppression in PWHA, with a mediation effect value (a*b) of -0.004 (95%CI: -0.244, -0.105). Conclusions In the XPCC, PWHA's viral load suppression rate hasn't met UNAIDS' "95-95-95" target. Priority should be given to PLWH with < 3 years of treatment and CD4 + T-cell count < 500 cells/µL. HIV-related education should be delivered to patients, families and the public to enhance social support and self-efficacy, reduce HIV-related stigma, and promote healthy lifestyles (e.g., reduced alcohol consumption). These measures will improve adherence to ART, thereby achieving effective viral load suppression. Acquired immunodeficiency syndrome Viral Load Non-suppression Mediation effects analysis Risk factors Introduction Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains a major global public health concern that has garnered sustained international attention. As of December 31, 2024, 31 provinces, autonomous regions, and municipalities directly under the Central Government of China had reported a total of 1,355,017 PWHA and 491,437 AIDS-related deaths [ 1 ] . The introduction of highly active antiretroviral therapy (HAART) has revolutionized the management of AIDS, effectively transforming it from a fatal condition into a manageable chronic infectious disease. Unlike most other chronic illnesses, however, HAART requires lifelong adherence to medication to maintain its therapeutic effects. UNAIDS has proposed the "95-95-95" target, which mandates that by 2030, at least 95% of PWHA who are on treatment achieve viral suppression [ 2 ] . The Chinese government has made substantial efforts, and the newly released China Plan for the Prevention and Control of AIDS (2024–2030) [ 3 ] reaffirms the commitment to exceed 95% viral suppression rate among treated PWHA by 2030. The Xinjiang Production and Construction Corps (XPCC), colloquially referred to as the "Xinjiang Corps," is a provincial-level special administrative unit under China’s separate state planning. As of January 2023, it has jurisdiction over 14 divisions.The XPCC and the Xinjiang Uygur Autonomous Region are two key entities in China’s Xinjiang region, both situated in the country’s northwestern border area, but they differ substantially in administrative level, responsibility scope, and jurisdiction. By the end of 2019, the XPCC had a total population of 3.2484 million. Epidemiological data indicate that between 1996 and 2021, the XPCC cumulatively identified and reported 1,936 PWHA, including 459 deaths and 1,477 survivors [ 4 ] . By the end of 2022, the cumulative number of reported HIV/AIDS cases in the XPCC had risen to 2,130 [ 5 ] . To clarify the current status of non-suppressed viral load among PWHA receiving ART in the XPCC, this study enrolled PWHA from selected areas within the XPCC. It investigated the prevalence of non-suppressed viral load and analyzed its influencing factors, with the aim of developing targeted ART adherence education. Such efforts are intended to enhance the quality of survival and overall quality of life of PWHA. Methods 1. Study population From December 2023 to September 2024, a total of 369 PWHA treated in designated HIV treatment hospitals of four divisions under the XPCC were selected as the study subjects. Follow-up nurses at the Voluntary Counseling and Testing (VCT) clinic explained the purpose and content of this survey to PWHA. After patients gave their consent and signed the informed consent form, the nurses conducted the questionnaire survey. 1.1 Inclusion criteria (1) Meet the diagnostic criteria specified in the Chinese Guidelines for the Diagnosis and Treatment of AIDS (2024 Edition) [ 6 ] ; (2) Be a permanent resident and aged ≥ 18 years; (3) Be receiving ART with a treatment duration of ≥ 6 months; (4) Voluntarily participate in the survey under the principle of informed consent. 1.2 Exclusion criteria Cases of being absent from the local area, lost to follow-up, deceased, or in custody at the time of the survey; Patients with severe physical or mental illnesses; Patients who refuse to participate in this survey. 1.3 Sample size calculation Based on previous studies, the expected overall viral load positivity rate was 25%. The sample size was calculated using the formula for cross-sectional studies. Z ɑ/2 =1.96, \(\:\text{δ}\) =0.05, the expected overall positivity rate of viral load was 25% (P = 25%). The calculated sample size was 300 cases. Considering a 20% attrition rate, the minimum sample size required for this study was finally calculated to be 360 cases. A total of 369 patients with HIV/AIDS were ultimately enrolled in this study. $$\:n=\frac{{\left({z}_{\alpha\:/2}\right)}^{2}\times\:P(1-P)}{{\delta\:}^{2}}$$ 2. Data collection Questionnaires were administered during the subjects' routine follow-up visits. Trained investigators first explained the survey details, and the survey was initiated only after the subjects signed the informed consent form. Elderly, digitally illiterate, and illiterate subjects completed the survey through one-on-one interviews, where investigators read the questions and recorded the answers. All other subjects accessed the questionnaires by scanning the QR codes provided on paper. Questionnaire content included: We collected the sociodemographic information and antiretroviral treatment-related data of PWHA using a General and Treatment Information Questionnaire. The Social Support Rating Scale (SSRS) [ 7 ] was adopted to investigate the current status of social support among the patients, with a Cronbach’s α coefficient of 0.860, a standardized Cronbach’s α coefficient of 0.873, a Kaiser-Meyer-Olkin (KMO) value of 0.773, and a Bartlett’s test of sphericity with P < 0.001. The HIV Treatment Adherence Self-Efficacy Scale (HIV-ASES-V2) [ 8 ] was used to assess the self-efficacy of HIV/AIDS patients, which showed a Cronbach’s α coefficient of 0.905, a standardized Cronbach’s α coefficient of 0.925, a KMO value of 0.753, and a Bartlett’s test of sphericity with P < 0.001. The Chinese version of the 8-Item Morisky Medication Adherence Scale (MMAS-8) [ 9 ] was employed to evaluate the current status of antiretroviral treatment adherence in HIV/AIDS patients, with a Cronbach’s α coefficient of 0.830, a standardized Cronbach’s α coefficient of 0.838, a KMO value of 0.716, and a Bartlett’s test of sphericity with P < 0.001. 3.Statistical Analysis Categorical variables were described using frequencies and composition ratios (n/%), while continuous variables were expressed as mean ± standard deviation (x̄±s). For inter-group comparisons, independent samples t-test, analysis of variance (ANOVA), or chi-square test (χ² test) was applied. Binary logistic regression analysis was performed to identify factors influencing viral load unsuppression. Mediating effect analysis was conducted to verify the mediating role of ART adherence in the associations between self-efficacy, social support, and viral load unsuppression. Results A total of 369 PWHA were included in the study, among whom 75 cases (17.62%) had positive viral load. In terms of demographic characteristics, the subjects were mainly males (301 cases, 81.57%), with 157 cases (42.55%) aged 35–55 years, 113 cases (30.62%) having college education or above, 146 cases (39.57%) with fixed jobs, and 185 cases (44.79%) being married or having partners. Regarding clinical and treatment-related characteristics of the 369 PWHA, the main transmission route was heterosexual contact (257 cases, 69.65%); 320 cases (86.72%) were at disease stage Ⅰ-Ⅱ, 242 cases (65.58%) received the ART regimen of NNRTI + 2NRTIs, and 170 cases (46.07%) had a CD4 + T-lymphocyte count ≥ 550 cells/µL. In terms of behavioral and social experience, 150 cases (40.65%) had a drinking history, 193 cases (52.30%) had a smoking history, 133 cases (36.04%) had experienced discrimination, and 42 cases (11.38%) had a history of being subjected to violence. (Table 1 ). 1. Univariate Analysis of Viral Load Non-Suppression in PWHA Univariate analysis was conducted with the viral load (VL) results of PWHA designated as the dependent variable. The analysis results demonstrated that several factors were associated with the VL results of PWHA, specifically: age, educational level, occupation type, marital status, transmission route, time of diagnosis, treatment duration, disease stage, CD4 + T-lymphocyte count, adverse drug reactions, drinking history, experiences of discrimination and violence, ART adherence, self-efficacy, and social support(Table 1 ). Table 1 Univariate Analysis of Viral Load Non-Suppression in PWHA Variables Total (n = 369) Negative (n = 304) Positive (n = 65) χ² P Age(year) 55.00 < 0.01 < 35 102 (27.64) 102 (32.48) 0 (0.00) 35~ 150 (40.65) 139 (44.27) 11 (20.00) ≥ 55 117 (31.71) 73 (23.25) 44 (80.00) Gender 0.00 0.95 Female 68 (18.43) 57 (18.15) 11 (20.00) Male 301 (81.57) 257 (81.85) 44 (80.00) Educational Level 34.78 < 0.01 Primary School and Below 81 (21.95) 38 (12.10) 43 (78.18) Junior High School 38 (10.30) 31 (9.87) 7 (12.73) Senior High School and Technical Secondary School 90 (24.39) 86 (27.39) 4 (7.27) College Education and Above 160 (43.36) 159 (50.64) 1 (1.82) employment type 12.05 < 0.01 Student 26 (7.05) 26 (8.28) 0 (0.00) Farmer/Manual Worker 87 (23.58) 72 (22.93) 15 (27.27) With Regular Employment 128 (34.69) 116 (36.94) 12 (21.82) Unemployed/Retired/Irregular Employment 128 (34.69) 100 (31.85) 28 (50.91) Marital Status 18.65 < 0.01 Never Married 138 (37.40) 131 (41.72) 7 (12.73) Married or in a Cohabiting Relationship 175 (47.43) 140 (44.59) 35 (63.64) Divorced/Widowed 56 (15.18) 43 (13.69) 13 (23.64) Transmission Route - < 0.01 Heterosexual Sexual Transmission 257 (69.65) 207 (65.92) 50 (90.91) Homosexual Sexual Transmission 99 (26.83) 95 (30.25) 4 (7.27) Mother-to-Child/Drug Injection/Blood Transfusion Transmission 13 (3.52) 12 (3.82) 1 (1.82) Duration Since HIV Diagnosis(Year) 4.90 0.03 ≤ 3 140 (37.94) 112 (35.67) 28 (50.91) >3 229 (62.06) 202 (64.33) 27 (49.09) Duration of ART (Years) 6.47 0.01 ≤ 3 152 (41.19) 122 (38.85) 30 (54.55) >3 217 (58.81) 192 (61.15) 25 (45.45) CD4 + T-Lymphocyte Count(cells/µL) 68.82 < 0.01 < 200 46 (12.47) 27 (8.60) 19 (34.55) 200~ 153 (41.46) 127 (40.45) 26 (47.27) ≥ 550 170 (46.07) 160 (50.96) 10 (18.18) Disease Stage 7.20 < 0.01 Ⅰ~Ⅱ 320 (86.72) 276 (87.90) 44 (80.00) Ⅲ~Ⅳ 49 (13.28) 38 (12.10) 11 (20.00) Adverse Reactions 5.71 0.02 No 116 (31.44) 107 (34.08) 9 (16.36) Yes 253 (68.56) 207 (65.92) 46 (83.64) Treatment Regimen 0.91 0.82 NNRTI + 2NRTIs 242 (65.58) 208 (66.24) 34 (61.82) PIs + 2NRTIs 40 (10.84) 33 (10.51) 7 (12.73) BIC/FTC/TAF 40 (10.84) 36 (11.46) 4 (7.27) Others 47 (12.74) 37 (11.78) 10 (18.18) Alcohol Consumption 35.15 < 0.01 No 203 (55.01) 197 (62.74) 6 (10.91) Yes 166 (44.99) 117 (37.26) 49 (89.09) Tobacco Smoking 0.52 0.47 No 176 (47.70) 151 (48.09) 25 (45.45) Yes 193 (52.30) 163 (51.91) 30 (54.55) Experience of Discrimination 31.92 < 0.01 No 280 (75.88) 273 (86.94) 7 (12.73) Yes 89 (24.12) 41 (13.06) 48 (87.27) Experience of Violence 9.24 < 0.01 No 327 (88.62) 285 (90.76) 42 (76.36) Yes 42 (11.38) 29 (9.24) 13 (23.64) ART Adherence 26.65 < 0.01 8分 36 (9.76) 35 (11.15) 1 (1.82) 6~分 125 (33.88) 116 (36.94) 9 (16.36) <6分 208 (56.37) 163 (51.91) 45 (81.82) Self-Efficacy 36.94 < 0.01 ≥ 110分 104 (28.18) 104 (33.12) 0 (0.00) <110分 265 (71.82) 210 (66.88) 55 (100.00) Social Support 108.74 < 0.01 ≥ 45分 246 (66.67) 239 (76.11) 7 (12.73) <45分 123 (33.33) 75 (23.89) 48 (87.27) 2. Binary Logistic Regression Analysis of Non-suppressed Viral Load in PWHA The results of unconditional binary logistic regression analysis showed that CD4 + T-lymphocyte count ≥ 550 cells/µL (OR = 0.01, 95%CI: 0.00 ~ 0.19, P = 0.002), duration of ART ≥ 3 years (OR = 0.05, 95%CI: 0.01 ~ 0.49, P = 0.010), drinking history (OR = 9.25, 95%CI: 2.24 ~ 38.31, P<0.01), experience of discrimination (OR = 8.50, 95%CI: 1.26 ~ 57.45, P = 0.028), ART adherence (OR = 0.15, 95%CI: 0.04 ~ 0.61, P = 0.008), and social support (OR = 0.74, 95%CI: 0.60 ~ 0.91, P = 0.005) were influencing factors for viral load unsuppression in PWHA(Table 2 ). Table 2 Binary Logistic Regression Analysis of Non-suppressed Viral Load in PWHA Variables β S.E Z P OR (95%CI) Intercept 11.57 3.82 3.03 0.002 10.64 (5.73 ~ 18.20) CD4 + T-Lymphocyte Count(cells/µL) < 200 1 200~ -1.68 1.31 -1.29 0.199 0.19 (0.01 ~ 2.42) ≥ 550 -4.40 1.40 -3.14 0.002 0.01 (0.00 ~ 0.19) Duration of ART (Years) <3 1 ≥ 3 -2.97 1.15 -2.58 0.010 0.05 (0.01 ~ 0.49) Alcohol Consumption No 1 Yes 2.22 0.72 3.07 < 0.01 9.25 (2.24 ~ 38.31) Experience of Violence No 1 Yes 2.14 0.97 2.20 0.028 8.50 (1.26 ~ 57.45) ART Adherence -1.88 0.71 -2.65 0.008 0.15 (0.04 ~ 0.61) Self-Efficacy -0.30 0.11 -2.81 0.005 0.74 (0.60 ~ 0.91) 3. The mediating effect of antiviral treatment adherence between self-efficacy and non-suppressed viral load The mediation analysis results indicated that the regression coefficient (c) for the total effect of self-efficacy on the unsuppressed viral load status was − 0.014 (P < 0.001). The regression coefficient (a) of self-efficacy on ART adherence was 0.104 (P < 0.001). The regression coefficient (b) of ART adherence for unsuppressed viral load was − 0.124 (P < 0.001). When ART adherence was incorporated into the model, self-efficacy displayed no direct effect on the regression coefficient for non-suppressed viral load in PWHA. This indicates that ART adherence fully mediates the relationship between self-efficacy and non-suppressed viral load in this population, with an effect size (a*b) of -0.012 (95% CI: -0.552, -0.213)(Table 3 ). Table 3 The mediating effect of antiviral treatment adherence between self-efficacy and non-suppressed viral load Mediator Sample Exposure to Mediator Mediator to Outcome Direct Effect Mediated (Indirect Effect) Total Effect(Exposure to Outcome) Proportion Mediated(%) ART Adherence 369 0.102 (0.003) p<0.001 -0.082 (0.018) p<0.001 -0.002 (0.002) P = 0.081 -0.012 (0.073) 95%CI(-0.522,-0.213) -0.014(0.001) p<0.001 100% 4. The mediating effect of antiviral treatment adherence between social support and non-suppressed viral load The mediation analysis results indicated that the regression coefficient c for the total effect of social support on unsuppressed viral load was − 0.026 (P < 0.001). The regression coefficient (a) of social support for adherence to ART was 0.193 (P < 0.001). The regression coefficient b of ART adherence for unsuppressed viral load was − 0.134 (P < 0.001). After incorporating adherence to ART into the model, self-efficacy exhibited no direct effect on the regression coefficient for non-suppressed viral load in PWHA. Adherence to ART fully mediated the relationship between social support and non-suppressed viral load in PWHA, with an effect size (a*b) of -0.026 (95% CI: -0.665, -0.389)(Table 4 ). Table 4 The mediating effect of antiviral treatment adherence between social support and non-suppressed viral load Mediator Sample Exposure to Mediator Mediator to Outcome Direct Effect Mediated(Indirect Effect) Total Effect(Exposure to Outcome) Proportion Mediated(%) ART Adherence 369 0.193 (0.007) p<0.001 -0.134 (0.017) p<0.001 -0.000 (0.004) P = 0.913 -0.026 (0.070) 95%CI(-0.665,-0.389) -0.026(0.003) p<0.001 100% 5. Chain mediating effect analysis The chain mediation analysis results showed that the total effect regression coefficient c of self-efficacy on unsuppressed viral load was − 0.015 (P < 0.001). The regression coefficient a of self-efficacy on social support was 0.457 (P < 0.001). The regression coefficient (a) of social support for adherence to ART was 0.075 (P < 0.001). The regression coefficient (b) of adherence to ART for unsuppressed viral load was − 0.127 (P < 0.001). After including the mediating variables in the model, the "social support ⇒ ART adherence" pathway played a partial chain-mediating role between self-efficacy and non-suppressed viral load in PWHA, with an effect value (a*b) of -0.004 (95% CI: -0.244, -0.105) (Table 4 ). Table 4 Analysis of the chain mediation effect of "social support ⇒ ART adherence" between self-efficacy and non-suppressed viral load Mediator Sample Exposure to Mediator1(M1) Mediator1(M1) to Mediator2(M2) Mediator2(M2) to Outcome Direct Effect Mediated(Indirect Effect) Total Effect(Exposure to Outcome) Proportion Mediated(%) Social Support(M1) ART Adherence(M2) 369 0.457 (0.013) p<0.001 0.075 (0.011) p<0.001 -0.127 (0.020) p<0.001 -0.002 (0.003) P = 0.464 -0.004 (0.035) 95%CI(-0.244,-0.105) -0.015 (0.001) p<0.001 26.67% Discussion This study is the first to investigate the current status of unsuppressed viral load among PWHA receiving ART in the XPCC, and to analyze the influencing factors of viral load non-suppression. The newly released Chinese guidelines for diagnosis and treatment of human immunodeficiency virus infection/acquired immunodeficiency syndrome (2024 edition) [ 10 ] states that the assessment of ART efficacy primarily focuses on virological, immunological, and clinical indicators, among which virological improvement serves as the most critical evaluation criterion. It also emphasizes that following the initiation of ART, follow-up evaluations of virological, immunological, and clinical status should be performed every 3–6 months to assess treatment outcomes and guide adjustments to ART regimens. Existing studies [ 11 , 12 ] have demonstrated that viral load is the optimal predictor of long-term clinical outcomes. Among the 369 enrolled PWHA, 304 cases (82.38%) had a negative viral load, and 65 cases (17.62%) had a positive viral load. Compared with the findings of Qian Y [ 13 ] , who reported an unsuppressed viral load rate of 20.80%, the proportion of PWHA with a positive viral load (i.e., unsuppressed viral load) in the XPCC exhibited a slight decrease. In comparison with other countries and regions, this proportion (17.62%) was lower than that in Puglia City, Italy (44.22%) [ 14 ] and Hawassa City, Ethiopia (59.10%) [ 15 ] , but higher than that in Japan (15.55%) [ 16 ] . When compared with other cities in China, it was lower than the rate in Luzhou City, Sichuan Province (25%) [ 17 ] , higher than that in the Dali region of Yunnan Province (15.03%) [ 18 ] , and relatively close to the national estimated unsuppressed viral load rate of 17.1% reported by Zhao [ 19 ] . This study demonstrates that PWHA with a CD4 + T lymphocyte count of ≥ 550 cells/µL are more likely to achieve viral load suppression than those with a count of < 200 cells/µL, a finding consistent with conclusions from relevant domestic and international studies. Patients with lower CD4 + T lymphocyte counts typically present with higher viral loads. A study by Boateng [ 20 ] further showed that compared with patients who had a CD4 + T lymphocyte count of ≥ 350 cells/µL, those with a count of < 350 cells/µL were more susceptible to viral load rebound. In this study, alcohol consumption was defined as consuming more than 7 drinks per week or ≥ 4 drinks on a single occasion [ 21 ] . The results showed that alcohol consumption was associated with unsuppressed viral load, similar to Mannen [ 22 ] . The proportion of alcohol consumption among PWHA ranges between 8% and 42% [ 23 ] . For PWHA, alcohol consumption not only increases the risk of HIV transmission (e.g., unprotected sex) [ 24 ] but also exerts a negative impact on the effectiveness of ART. These adverse effects include reduced ART adherence, failure of immune function recovery, unsuppressed viral load, and even elevated risks of treatment failure and mortality [ 25 ] . Additionally, studies by Wynn [ 26 ] and Cachay [ 27 ] have indicated that alcohol consumption leads to higher viral load by reducing adherence to ART. This study found that experiencing discrimination is one of the factors affecting viral load suppression in PWHA, similar to Yigit’s [ 28 ] reserach. Previous research has indicated that stigmatization constitutes a major obstacle to achieving the "90-90-90" targets [ 29 ] . Specifically, it reduces the willingness of HIV-negative individuals to undergo HIV testing, hinders the effective linkage between PWHA and healthcare providers, and exerts a negative impact on patients' treatment adherence as well as viral load suppression outcomes.Additionally, the findings of Oryokot [ 30 ] and Mukuku [ 31 ] have shown that internalized family stigma, combined with external stigmatization and discrimination, prevents PWHA from achieving optimal viral suppression. This study found that higher self-efficacy was associated with better viral load suppression, similar to Umar [ 32 ] . Self-efficacy is defined as an individual's perceived ability to adhere to HIV treatment regimens, including ART, and this ability is associated with better treatment adherence [ 33 ] . The prospective cohort observational study conducted by Spence [ 34 ] on women living with HIV showed that patients with higher HIV treatment self-efficacy were more likely to achieve viral suppression. The findings of Crockett [ 35 ] revealed that depressive symptoms in PWHA indirectly reduce their adherence to ART by diminishing self-efficacy, thereby leading to suboptimal viral suppression. Conversely, the study by Yigit [ 36 ] demonstrated that the alleviation of internalized stigma could indirectly improve both ART adherence and viral load suppression in PWHA through enhanced self-efficacy. This study demonstrates that adherence to ART is a protective factor for viral load suppression in PWHA, similar to Mukuku [ 37 ] . ART adherence is defined as strict compliance with the treatment regimen prescribed by healthcare providers, including taking the correct dosage of medication at the right time and in the proper manner [ 38 ] . PWHA often exhibit non-adherence to treatment due to reasons such as "forgetting to take medication," "failing to carry drugs when going out," "being occupied with other matters," "fearing disclosure of their condition when outside," or "choosing to discontinue treatment after improvements in immune function" [ 39 , 40 ] , and such non-adherence leads to viral load rebound [ 37 ] . A follow-up study conducted by Tchakoute [ 41 ] on PWHA in California, USA, demonstrated that ART adherence exerts an impact on both virological and immunological indicators: every 10% increase in adherence was associated with a 37% higher probability of viral suppression, as well as an average increase of 8.54 CD4 cells/µL within the subsequent six months. Additionally,A study by Glass [ 42 ] showed that self-reported missed doses of ART (two or more times) were associated with an increased risk of treatment failure and death. In contrast, research by Norcini-Pala [ 43 ] demonstrated that ART adherence may serve as a mediating factor—intersecting stigma triggered by factors such as poverty, gender, and race could potentially increase the risk of unsuppressed viral load by contributing to poor ART adherence. Conversely, robust social support, high confidence in treatment, fewer ART-related side effects, and adequate nutrition can help patients achieve good treatment adherence, and consistent medication intake is conducive to achieving viral suppression [ 44 ] . Conclusions In summary, among 369 PWHA in the XPCC region, 65 cases (17.62%) had a positive viral load, indicating that the current status of unsuppressed viral load still requires improvement. The study identified that CD4 + T lymphocyte count ≥ 550 cells/µL, treatment duration ≥ 3 years, history of alcohol consumption, experience of discrimination, ART adherence, and self-efficacy are factors influencing unsuppressed viral load in PWHA. ART adherence is a key factor and can serve as a mediating factor that mediates the effects of social support, self-efficacy, and other factors on viral load.To facilitate the achievement of viral load suppression, targeted measures should include: strengthening precise clinical intervention for key patient groups, enhancing patients’ ART adherence and self-efficacy through diverse approaches, and improving the social support system that combines anti-discrimination publicity with multi-dimensional support. Abbreviations PWHA patients with HIV/AIDS XPCC Xinjiang Production and Construction Corps HIV/AIDS Human immunodeficiency virus/acquired immunodeficiency syndrome HAART highly active antiretroviral therapy ART antiretroviral therapy UNAIDS Joint United Nations Program on HIV/AIDS VCT Voluntary Counseling and Testing VL viral load NNRTI Non-Nucleoside Reverse Transcriptase Inhibitor NRTIs Nucleoside Reverse Transcriptase Inhibitors PIs Protease Inhibitors Declarations Ethics approval and consent to participate We certify that the study was conducted in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study protocol and the waiver of informed consent were approved by the Ethics Review Committee of the First Affiliated Hospital of Shihezi University (No.: KJ2023-311-01). Informed consent was obtained from all participants prior to the administration of the questionnaire. Consent for publication: Not applicable. Availability of data and materials The information of PWHA shall be strictly kept confidential.We will require all interested parties to provide the data request in writing. It shall require the approval of both the hospital and the local Center for Disease Control and Prevention (CDC).Once agreed to, data transfer agreements will be developed. All data transfers must comply with all applicable Zambian regulatory requirements.All data usage must comply with all applicable China`s regulatory requirements. Competing interests There are no relevant financial or non-financial conflicts of interest to declare Funding : Supported by the Special Fund for Basic Scientific Research Operations of the Central-Level Public Welfare Research Institutes of the Chinese Academy of Medical Sciences(2020-PT330-003). Guided Science and Technology Program Projects of the Xinjiang Production and Construction Corps(2022ZD026).The Young and Middle - Aged Backbone Medical Talents Sub - project under the Medical and Health High - level Talents Program of the "Tianshan Talents" Initiative in the 3rd Batch of the "2 + 5" Key Talent Program(TSYC202401B078) Authors’ contributions Conceptualization: B·N, Y Du, W He and S Xie. Methodology: B·N, S Xie. Data curation and formal analysis: B·N. Writing—original draft: B·N, Y Du, W He. Writing—review and editing: W He, Y Du, S Xie, B·N. Acknowledgements Not applicable. References National Center for AIDS/STD Control and Prevention, China CDC. National AIDS STD epidemic, December 2024[J]. Chin J AIDS STD. 2025;31(03):225. United Nations General Assembly. Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030[Z]. 2021. General Office of the State Council. 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Cachay ER, Moges TS, Qin H, et al. Effects of drug and hazardous alcohol use on having a detectable HIV viral load: An adherence mediation analysis. Addict Behav Rep. 2023;17:100486. Yigit I, Wilson TE, Taylor TN, et al. Association of experienced stigma in healthcare settings with health outcomes among Black women living with HIV: Mediating roles of internalized stigma, anticipated stigma, and trust in HIV care. Soc Sci Med. 2025;366:117699. NYBLADE L, MINGKWAN P, STOCKTON MA. Stigma reduction: an essential ingredient to ending AIDS by 2030[J]. Lancet HIV. 2021;8(2):e106–13. Oryokot B, Kazibwe A, Oluka AI, et al. Swallowing these drugs every day, you get tired: a mixed-methods study to identify barriers and facilitators to retention and HIV viral load suppression among the adolescents living with HIV in TASO Mbale and TASO Soroti centers of excellence. AIDS Res Ther. 2025;22(1):43. Mukuku O, Govender K, Wembonyama SO. Barriers and facilitators to HIV viral load suppression among adolescents living with HIV in Lubumbashi, Democratic Republic of the Congo: A qualitative study. PLoS ONE. 2025;20(3):e0320417. Umar E, Levy JA, Bailey RC, et al. Virological Non-suppression and Its Correlates Among Adolescents and Young People Living with HIV in Southern Malawi. AIDS Behav. 2019;23(2):513–22. JIANG Y, LI X. Effects of individual and neighborhood socioeconomic status on antiretroviral therapy adherence: The role of adherence self-efficacy[J]. J Health Psychol. 2021;26(8):1143–53. Spence AB, Michel K, Wang C, et al. Viral Suppression Is Associated with HIV Treatment Self-Efficacy in a Cohort of Women in Washington, DC. AIDS Patient Care STDS. 2021;35(3):75–83. Crockett KB, Entler KJ, Brodie E, et al. Brief Report: Linking Depressive Symptoms to Viral Nonsuppression Among Women With HIV Through Adherence Self-Efficacy and ART Adherence. J Acquir Immune Defic Syndr. 2020;83(4):340–4. Yigit I, Bayramoglu Y, Weiser SD, et al. Changes in Internalized Stigma and HIV Health Outcomes in Individuals New to HIV Care: The Mediating Roles of Depression and Treatment Self-Efficacy. AIDS Patient Care STDS. 2020;34(11):491–7. Mukuku O, Govender K, Wembonyama SO. Prevalence and determinants of unsuppressed HIV viral loads among children and adolescents living with HIV on antiretroviral therapy in Lubumbashi, Democratic Republic of the Congo: a retrospective cross-sectional study. BMJ Open. 2025;15(7):e094657. Tian CC, Li H, Xiao YK, et al. ART adherence and related impact factors among AIDS patients[J]. Chin J AIDS STD. 2013;19(05):381–4. Kim MH, Mazenga AC, Yu X, et al. High self-reported non-adherence to antiretroviral therapy amongst adolescents living with HIV in Malawi: barriers and associated factors. J Int AIDS Soc. 2017;20(1):21437. Nguyen PM, Thach AN, Pham XD, et al. Prevalence and Determinants of Medication Adherence among Patients with HIV/AIDS in Southern Vietnam. Infect Dis Rep. 2021;13(1):126–35. Tchakoute T, Rhee C, Hare SY. Adherence to contemporary antiretroviral treatment regimens and impact on immunological and virologic outcomes in a US healthcare system. PLoS ONE. 2022;17(2):e0263742. Glass TR, Sterne JA, Schneider MP, et al. Swiss HIV Cohort Study. Self-reported nonadherence to antiretroviral therapy as a predictor of viral failure and mortality. AIDS. 2015;29(16):2195–200. Norcini-Pala A, Stringer KL, Kempf MC, et al. Longitudinal associations between intersectional stigmas, antiretroviral therapy adherence, and viral load among women living with HIV using multidimensional latent transition item response analysis. Soc Sci Med. 2025;366:117643. Daltro ACB, Almeida CS, Unfried AGC, et al. Virological failure and adherence to antiretroviral therapy in adolescents and young adults living with human immunodeficiency virus. Trop Med Int Health. 2023;28(3):162–74. Additional Declarations No competing interests reported. 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therapy","fulltext":[{"header":"Introduction","content":"\u003cp\u003eHuman immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains a major global public health concern that has garnered sustained international attention. As of December 31, 2024, 31 provinces, autonomous regions, and municipalities directly under the Central Government of China had reported a total of 1,355,017 PWHA and 491,437 AIDS-related deaths\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. The introduction of highly active antiretroviral therapy (HAART) has revolutionized the management of AIDS, effectively transforming it from a fatal condition into a manageable chronic infectious disease. Unlike most other chronic illnesses, however, HAART requires lifelong adherence to medication to maintain its therapeutic effects.\u003c/p\u003e \u003cp\u003eUNAIDS has proposed the \"95-95-95\" target, which mandates that by 2030, at least 95% of PWHA who are on treatment achieve viral suppression\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. The Chinese government has made substantial efforts, and the newly released China Plan for the Prevention and Control of AIDS (2024\u0026ndash;2030)\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e reaffirms the commitment to exceed 95% viral suppression rate among treated PWHA by 2030.\u003c/p\u003e \u003cp\u003eThe Xinjiang Production and Construction Corps (XPCC), colloquially referred to as the \"Xinjiang Corps,\" is a provincial-level special administrative unit under China\u0026rsquo;s separate state planning. As of January 2023, it has jurisdiction over 14 divisions.The XPCC and the Xinjiang Uygur Autonomous Region are two key entities in China\u0026rsquo;s Xinjiang region, both situated in the country\u0026rsquo;s northwestern border area, but they differ substantially in administrative level, responsibility scope, and jurisdiction. By the end of 2019, the XPCC had a total population of 3.2484\u0026nbsp;million.\u003c/p\u003e \u003cp\u003eEpidemiological data indicate that between 1996 and 2021, the XPCC cumulatively identified and reported 1,936 PWHA, including 459 deaths and 1,477 survivors\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. By the end of 2022, the cumulative number of reported HIV/AIDS cases in the XPCC had risen to 2,130\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eTo clarify the current status of non-suppressed viral load among PWHA receiving ART in the XPCC, this study enrolled PWHA from selected areas within the XPCC. It investigated the prevalence of non-suppressed viral load and analyzed its influencing factors, with the aim of developing targeted ART adherence education. Such efforts are intended to enhance the quality of survival and overall quality of life of PWHA.\u003c/p\u003e "},{"header":"Methods","content":"\u003ch3\u003e1. Study population\u003c/h3\u003e\n\u003cp\u003eFrom December 2023 to September 2024, a total of 369 PWHA treated in designated HIV treatment hospitals of four divisions under the XPCC were selected as the study subjects. Follow-up nurses at the Voluntary Counseling and Testing (VCT) clinic explained the purpose and content of this survey to PWHA. After patients gave their consent and signed the informed consent form, the nurses conducted the questionnaire survey.\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n\u003ch2\u003e1.1 Inclusion criteria\u003c/h2\u003e\n(1) Meet the diagnostic criteria specified in the Chinese Guidelines for the Diagnosis and Treatment of AIDS (2024 Edition)\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e;\u003cbr /\u003e\n\u003cp\u003e(2) Be a permanent resident and aged\u0026thinsp;\u0026ge;\u0026thinsp;18 years;\u003c/p\u003e\n\u003cp\u003e(3) Be receiving ART with a treatment duration of \u0026ge;\u0026thinsp;6 months;\u003c/p\u003e\n\u003cp\u003e(4) Voluntarily participate in the survey under the principle of informed consent.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n\u003ch2\u003e1.2 Exclusion criteria\u003c/h2\u003e\n\u003col\u003e\n\u003cli\u003e\n\u003cp\u003eCases of being absent from the local area, lost to follow-up, deceased, or in custody at the time of the survey;\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003ePatients with severe physical or mental illnesses;\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003ePatients who refuse to participate in this survey.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ol\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n\u003ch2\u003e1.3 Sample size calculation\u003c/h2\u003e\nBased on previous studies, the expected overall viral load positivity rate was 25%. The sample size was calculated using the formula for cross-sectional studies. Z\u003csub\u003eɑ/2\u003c/sub\u003e=1.96, \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\text{\u0026delta;}\\)\u003c/span\u003e\u003c/span\u003e=0.05, the expected overall positivity rate of viral load was 25% (P\u0026thinsp;=\u0026thinsp;25%). The calculated sample size was 300 cases. Considering a 20% attrition rate, the minimum sample size required for this study was finally calculated to be 360 cases. A total of 369 patients with HIV/AIDS were ultimately enrolled in this study.\u003c/div\u003e\n\u003cdiv class=\"Section2\"\u003e$$\\:n=\\frac{{\\left({z}_{\\alpha\\:/2}\\right)}^{2}\\times\\:P(1-P)}{{\\delta\\:}^{2}}$$\u003c/div\u003e\n\u003ch3\u003e2. Data collection\u003c/h3\u003e\n\u003cp\u003eQuestionnaires were administered during the subjects' routine follow-up visits. Trained investigators first explained the survey details, and the survey was initiated only after the subjects signed the informed consent form. Elderly, digitally illiterate, and illiterate subjects completed the survey through one-on-one interviews, where investigators read the questions and recorded the answers. All other subjects accessed the questionnaires by scanning the QR codes provided on paper.\u003c/p\u003e\n\u003cp\u003eQuestionnaire content included:\u003c/p\u003e\n\u003cp\u003eWe collected the sociodemographic information and antiretroviral treatment-related data of PWHA using a General and Treatment Information Questionnaire. The Social Support Rating Scale (SSRS)\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003ewas adopted to investigate the current status of social support among the patients, with a Cronbach\u0026rsquo;s \u0026alpha; coefficient of 0.860, a standardized Cronbach\u0026rsquo;s \u0026alpha; coefficient of 0.873, a Kaiser-Meyer-Olkin (KMO) value of 0.773, and a Bartlett\u0026rsquo;s test of sphericity with P\u0026thinsp;\u0026lt;\u0026thinsp;0.001. The HIV Treatment Adherence Self-Efficacy Scale (HIV-ASES-V2)\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e was used to assess the self-efficacy of HIV/AIDS patients, which showed a Cronbach\u0026rsquo;s \u0026alpha; coefficient of 0.905, a standardized Cronbach\u0026rsquo;s \u0026alpha; coefficient of 0.925, a KMO value of 0.753, and a Bartlett\u0026rsquo;s test of sphericity with P\u0026thinsp;\u0026lt;\u0026thinsp;0.001. The Chinese version of the 8-Item Morisky Medication Adherence Scale (MMAS-8)\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e was employed to evaluate the current status of antiretroviral treatment adherence in HIV/AIDS patients, with a Cronbach\u0026rsquo;s \u0026alpha; coefficient of 0.830, a standardized Cronbach\u0026rsquo;s \u0026alpha; coefficient of 0.838, a KMO value of 0.716, and a Bartlett\u0026rsquo;s test of sphericity with P\u0026thinsp;\u0026lt;\u0026thinsp;0.001.\u003c/p\u003e\n\u003ch3\u003e3.Statistical Analysis\u003c/h3\u003e\n\u003cp\u003eCategorical variables were described using frequencies and composition ratios (n/%), while continuous variables were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (x̄\u0026plusmn;s). For inter-group comparisons, independent samples t-test, analysis of variance (ANOVA), or chi-square test (\u0026chi;\u0026sup2; test) was applied. Binary logistic regression analysis was performed to identify factors influencing viral load unsuppression. Mediating effect analysis was conducted to verify the mediating role of ART adherence in the associations between self-efficacy, social support, and viral load unsuppression.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 369 PWHA were included in the study, among whom 75 cases (17.62%) had positive viral load. In terms of demographic characteristics, the subjects were mainly males (301 cases, 81.57%), with 157 cases (42.55%) aged 35\u0026ndash;55 years, 113 cases (30.62%) having college education or above, 146 cases (39.57%) with fixed jobs, and 185 cases (44.79%) being married or having partners. Regarding clinical and treatment-related characteristics of the 369 PWHA, the main transmission route was heterosexual contact (257 cases, 69.65%); 320 cases (86.72%) were at disease stage Ⅰ-Ⅱ, 242 cases (65.58%) received the ART regimen of NNRTI\u0026thinsp;+\u0026thinsp;2NRTIs, and 170 cases (46.07%) had a CD4\u0026thinsp;+\u0026thinsp;T-lymphocyte count\u0026thinsp;\u0026ge;\u0026thinsp;550 cells/\u0026micro;L. In terms of behavioral and social experience, 150 cases (40.65%) had a drinking history, 193 cases (52.30%) had a smoking history, 133 cases (36.04%) had experienced discrimination, and 42 cases (11.38%) had a history of being subjected to violence. (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003e1. Univariate Analysis of Viral Load Non-Suppression in PWHA\u003c/h3\u003e\n\u003cp\u003eUnivariate analysis was conducted with the viral load (VL) results of PWHA designated as the dependent variable. The analysis results demonstrated that several factors were associated with the VL results of PWHA, specifically: age, educational level, occupation type, marital status, transmission route, time of diagnosis, treatment duration, disease stage, CD4\u0026thinsp;+\u0026thinsp;T-lymphocyte count, adverse drug reactions, drinking history, experiences of discrimination and violence, ART adherence, self-efficacy, and social support(Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate Analysis of Viral Load Non-Suppression in PWHA\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;369)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNegative (n\u0026thinsp;=\u0026thinsp;304)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePositive (n\u0026thinsp;=\u0026thinsp;65)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eχ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge(year)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e102 (27.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e102 (32.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35~\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e150 (40.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e139 (44.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e117 (31.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73 (23.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44 (80.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.95\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68 (18.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57 (18.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e301 (81.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e257 (81.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44 (80.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducational Level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary School and Below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81 (21.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38 (12.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43 (78.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJunior High School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38 (10.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31 (9.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (12.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior High School and Technical Secondary School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e90 (24.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e86 (27.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 (7.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollege Education and Above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e160 (43.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e159 (50.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (1.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eemployment type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26 (7.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (8.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFarmer/Manual Worker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e87 (23.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72 (22.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15 (27.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWith Regular Employment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e128 (34.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e116 (36.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12 (21.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed/Retired/Irregular Employment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e128 (34.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100 (31.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28 (50.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever Married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e138 (37.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e131 (41.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (12.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried or in a Cohabiting Relationship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e175 (47.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e140 (44.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35 (63.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced/Widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e56 (15.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43 (13.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13 (23.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTransmission Route\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeterosexual Sexual Transmission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e257 (69.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e207 (65.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e50 (90.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHomosexual Sexual Transmission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e99 (26.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e95 (30.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 (7.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMother-to-Child/Drug Injection/Blood Transfusion Transmission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13 (3.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (3.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (1.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration Since HIV Diagnosis(Year)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e140 (37.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112 (35.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28 (50.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e229 (62.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e202 (64.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27 (49.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of ART (Years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e152 (41.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e122 (38.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30 (54.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e217 (58.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e192 (61.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25 (45.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCD4\u0026thinsp;+\u0026thinsp;T-Lymphocyte Count(cells/\u0026micro;L)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e68.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e46 (12.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (8.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19 (34.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e200~\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e153 (41.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e127 (40.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26 (47.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;550\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e170 (46.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e160 (50.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (18.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDisease Stage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eⅠ~Ⅱ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e320 (86.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e276 (87.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44 (80.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eⅢ~Ⅳ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49 (13.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38 (12.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAdverse Reactions\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e116 (31.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e107 (34.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (16.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e253 (68.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e207 (65.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e46 (83.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTreatment Regimen\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNNRTI\u0026thinsp;+\u0026thinsp;2NRTIs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e242 (65.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e208 (66.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34 (61.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePIs\u0026thinsp;+\u0026thinsp;2NRTIs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40 (10.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (10.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (12.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBIC/FTC/TAF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40 (10.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (11.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 (7.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47 (12.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37 (11.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (18.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAlcohol Consumption\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e203 (55.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e197 (62.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6 (10.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e166 (44.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e117 (37.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49 (89.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTobacco Smoking\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e176 (47.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e151 (48.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25 (45.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e193 (52.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e163 (51.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30 (54.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eExperience of Discrimination\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e280 (75.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e273 (86.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (12.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e89 (24.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41 (13.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48 (87.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eExperience of Violence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e327 (88.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e285 (90.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42 (76.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42 (11.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29 (9.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13 (23.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eART Adherence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e26.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8分\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36 (9.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35 (11.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (1.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6~分\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e125 (33.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e116 (36.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (16.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;6分\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e208 (56.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e163 (51.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45 (81.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-Efficacy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;110分\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e104 (28.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e104 (33.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;110分\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e265 (71.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e210 (66.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e55 (100.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSocial Support\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e108.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;45分\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e246 (66.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e239 (76.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (12.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;45分\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e123 (33.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75 (23.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48 (87.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003e2. Binary Logistic Regression Analysis of Non-suppressed Viral Load in PWHA\u003c/h3\u003e\n\u003cp\u003eThe results of unconditional binary logistic regression analysis showed that CD4\u0026thinsp;+\u0026thinsp;T-lymphocyte count\u0026thinsp;\u0026ge;\u0026thinsp;550 cells/\u0026micro;L (OR\u0026thinsp;=\u0026thinsp;0.01, 95%CI: 0.00\u0026thinsp;~\u0026thinsp;0.19, P\u0026thinsp;=\u0026thinsp;0.002), duration of ART\u0026thinsp;\u0026ge;\u0026thinsp;3 years (OR\u0026thinsp;=\u0026thinsp;0.05, 95%CI: 0.01\u0026thinsp;~\u0026thinsp;0.49, P\u0026thinsp;=\u0026thinsp;0.010), drinking history (OR\u0026thinsp;=\u0026thinsp;9.25, 95%CI: 2.24\u0026thinsp;~\u0026thinsp;38.31, P\u0026lt;0.01), experience of discrimination (OR\u0026thinsp;=\u0026thinsp;8.50, 95%CI: 1.26\u0026thinsp;~\u0026thinsp;57.45, P\u0026thinsp;=\u0026thinsp;0.028), ART adherence (OR\u0026thinsp;=\u0026thinsp;0.15, 95%CI: 0.04\u0026thinsp;~\u0026thinsp;0.61, P\u0026thinsp;=\u0026thinsp;0.008), and social support (OR\u0026thinsp;=\u0026thinsp;0.74, 95%CI: 0.60\u0026thinsp;~\u0026thinsp;0.91, P\u0026thinsp;=\u0026thinsp;0.005) were influencing factors for viral load unsuppression in PWHA(Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBinary Logistic Regression Analysis of Non-suppressed Viral Load in PWHA\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eS.E\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eZ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntercept\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.64 (5.73\u0026thinsp;~\u0026thinsp;18.20)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCD4\u0026thinsp;+\u0026thinsp;T-Lymphocyte Count(cells/\u0026micro;L)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e200~\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.19 (0.01\u0026thinsp;~\u0026thinsp;2.42)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;550\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-4.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-3.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.01 (0.00\u0026thinsp;~\u0026thinsp;0.19)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of ART (Years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-2.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-2.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.05 (0.01\u0026thinsp;~\u0026thinsp;0.49)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAlcohol Consumption\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9.25 (2.24\u0026thinsp;~\u0026thinsp;38.31)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eExperience of Violence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.50 (1.26\u0026thinsp;~\u0026thinsp;57.45)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eART Adherence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-2.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.15 (0.04\u0026thinsp;~\u0026thinsp;0.61)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-Efficacy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-2.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.74 (0.60\u0026thinsp;~\u0026thinsp;0.91)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003e3. The mediating effect of antiviral treatment adherence between self-efficacy and non-suppressed viral load\u003c/h3\u003e\n\u003cp\u003eThe mediation analysis results indicated that the regression coefficient (c) for the total effect of self-efficacy on the unsuppressed viral load status was \u0026minus;\u0026thinsp;0.014 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The regression coefficient (a) of self-efficacy on ART adherence was 0.104 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The regression coefficient (b) of ART adherence for unsuppressed viral load was \u0026minus;\u0026thinsp;0.124 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). When ART adherence was incorporated into the model, self-efficacy displayed no direct effect on the regression coefficient for non-suppressed viral load in PWHA. This indicates that ART adherence fully mediates the relationship between self-efficacy and non-suppressed viral load in this population, with an effect size (a*b) of -0.012 (95% CI: -0.552, -0.213)(Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe mediating effect of antiviral treatment adherence between self-efficacy and non-suppressed viral load\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMediator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSample\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExposure to Mediator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMediator to Outcome\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDirect Effect\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMediated\u003c/p\u003e \u003cp\u003e(Indirect Effect)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTotal Effect(Exposure to Outcome)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eProportion Mediated(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eART Adherence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e369\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.102\u003c/p\u003e \u003cp\u003e(0.003)\u003c/p\u003e \u003cp\u003ep\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.082\u003c/p\u003e \u003cp\u003e(0.018)\u003c/p\u003e \u003cp\u003ep\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.002\u003c/p\u003e \u003cp\u003e(0.002)\u003c/p\u003e \u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.012\u003c/p\u003e \u003cp\u003e(0.073)\u003c/p\u003e \u003cp\u003e95%CI(-0.522,-0.213)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.014(0.001)\u003c/p\u003e \u003cp\u003ep\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e100%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003e4. The mediating effect of antiviral treatment adherence between social support and non-suppressed viral load\u003c/h3\u003e\n\u003cp\u003eThe mediation analysis results indicated that the regression coefficient c for the total effect of social support on unsuppressed viral load was \u0026minus;\u0026thinsp;0.026 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The regression coefficient (a) of social support for adherence to ART was 0.193 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The regression coefficient b of ART adherence for unsuppressed viral load was \u0026minus;\u0026thinsp;0.134 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). After incorporating adherence to ART into the model, self-efficacy exhibited no direct effect on the regression coefficient for non-suppressed viral load in PWHA. Adherence to ART fully mediated the relationship between social support and non-suppressed viral load in PWHA, with an effect size (a*b) of -0.026 (95% CI: -0.665, -0.389)(Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe mediating effect of antiviral treatment adherence between social support and non-suppressed viral load\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMediator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSample\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExposure to Mediator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMediator to Outcome\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDirect Effect\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMediated(Indirect Effect)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTotal Effect(Exposure to Outcome)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eProportion Mediated(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eART Adherence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e369\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.193\u003c/p\u003e \u003cp\u003e(0.007)\u003c/p\u003e \u003cp\u003ep\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.134\u003c/p\u003e \u003cp\u003e(0.017)\u003c/p\u003e \u003cp\u003ep\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.000\u003c/p\u003e \u003cp\u003e(0.004)\u003c/p\u003e \u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.913\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.026\u003c/p\u003e \u003cp\u003e(0.070)\u003c/p\u003e \u003cp\u003e95%CI(-0.665,-0.389)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.026(0.003)\u003c/p\u003e \u003cp\u003ep\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e100%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003e5. Chain mediating effect analysis\u003c/h3\u003e\n\u003cp\u003eThe chain mediation analysis results showed that the total effect regression coefficient c of self-efficacy on unsuppressed viral load was \u0026minus;\u0026thinsp;0.015 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The regression coefficient a of self-efficacy on social support was 0.457 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The regression coefficient (a) of social support for adherence to ART was 0.075 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The regression coefficient (b) of adherence to ART for unsuppressed viral load was \u0026minus;\u0026thinsp;0.127 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). After including the mediating variables in the model, the \"social support \u0026rArr; ART adherence\" pathway played a partial chain-mediating role between self-efficacy and non-suppressed viral load in PWHA, with an effect value (a*b) of -0.004 (95% CI: -0.244, -0.105) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAnalysis of the chain mediation effect of \"social support \u0026rArr; ART adherence\" between self-efficacy and non-suppressed viral load\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMediator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSample\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExposure to Mediator1(M1)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMediator1(M1) to Mediator2(M2)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMediator2(M2) to Outcome\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDirect Effect\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMediated(Indirect Effect)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eTotal Effect(Exposure to Outcome)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eProportion Mediated(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial Support(M1)\u003c/p\u003e \u003cp\u003eART Adherence(M2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e369\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.457\u003c/p\u003e \u003cp\u003e(0.013)\u003c/p\u003e \u003cp\u003ep\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.075\u003c/p\u003e \u003cp\u003e(0.011)\u003c/p\u003e \u003cp\u003ep\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.127\u003c/p\u003e \u003cp\u003e(0.020)\u003c/p\u003e \u003cp\u003ep\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.002\u003c/p\u003e \u003cp\u003e(0.003)\u003c/p\u003e \u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.464\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.004\u003c/p\u003e \u003cp\u003e(0.035)\u003c/p\u003e \u003cp\u003e95%CI(-0.244,-0.105)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.015\u003c/p\u003e \u003cp\u003e(0.001)\u003c/p\u003e \u003cp\u003ep\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e26.67%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study is the first to investigate the current status of unsuppressed viral load among PWHA receiving ART in the XPCC, and to analyze the influencing factors of viral load non-suppression.\u003c/p\u003e \u003cp\u003eThe newly released Chinese guidelines for diagnosis and treatment of human immunodeficiency virus infection/acquired immunodeficiency syndrome (2024 edition)\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e states that the assessment of ART efficacy primarily focuses on virological, immunological, and clinical indicators, among which virological improvement serves as the most critical evaluation criterion. It also emphasizes that following the initiation of ART, follow-up evaluations of virological, immunological, and clinical status should be performed every 3\u0026ndash;6 months to assess treatment outcomes and guide adjustments to ART regimens. Existing studies\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e have demonstrated that viral load is the optimal predictor of long-term clinical outcomes.\u003c/p\u003e \u003cp\u003eAmong the 369 enrolled PWHA, 304 cases (82.38%) had a negative viral load, and 65 cases (17.62%) had a positive viral load. Compared with the findings of Qian Y\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e, who reported an unsuppressed viral load rate of 20.80%, the proportion of PWHA with a positive viral load (i.e., unsuppressed viral load) in the XPCC exhibited a slight decrease. In comparison with other countries and regions, this proportion (17.62%) was lower than that in Puglia City, Italy (44.22%) \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e and Hawassa City, Ethiopia (59.10%) \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e, but higher than that in Japan (15.55%)\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e. When compared with other cities in China, it was lower than the rate in Luzhou City, Sichuan Province (25%)\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e, higher than that in the Dali region of Yunnan Province (15.03%)\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e, and relatively close to the national estimated unsuppressed viral load rate of 17.1% reported by Zhao\u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThis study demonstrates that PWHA with a CD4\u0026thinsp;+\u0026thinsp;T lymphocyte count of \u0026ge;\u0026thinsp;550 cells/\u0026micro;L are more likely to achieve viral load suppression than those with a count of \u0026lt;\u0026thinsp;200 cells/\u0026micro;L, a finding consistent with conclusions from relevant domestic and international studies. Patients with lower CD4\u0026thinsp;+\u0026thinsp;T lymphocyte counts typically present with higher viral loads. A study by Boateng\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e further showed that compared with patients who had a CD4\u0026thinsp;+\u0026thinsp;T lymphocyte count of \u0026ge;\u0026thinsp;350 cells/\u0026micro;L, those with a count of \u0026lt;\u0026thinsp;350 cells/\u0026micro;L were more susceptible to viral load rebound.\u003c/p\u003e \u003cp\u003eIn this study, alcohol consumption was defined as consuming more than 7 drinks per week or \u0026ge;\u0026thinsp;4 drinks on a single occasion\u003csup\u003e[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. The results showed that alcohol consumption was associated with unsuppressed viral load, similar to Mannen\u003csup\u003e[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e. The proportion of alcohol consumption among PWHA ranges between 8% and 42%\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e. For PWHA, alcohol consumption not only increases the risk of HIV transmission (e.g., unprotected sex)\u003csup\u003e[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e but also exerts a negative impact on the effectiveness of ART. These adverse effects include reduced ART adherence, failure of immune function recovery, unsuppressed viral load, and even elevated risks of treatment failure and mortality\u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e. Additionally, studies by Wynn\u003csup\u003e[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e and Cachay\u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e have indicated that alcohol consumption leads to higher viral load by reducing adherence to ART.\u003c/p\u003e \u003cp\u003eThis study found that experiencing discrimination is one of the factors affecting viral load suppression in PWHA, similar to Yigit\u0026rsquo;s\u003csup\u003e[\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003ereserach. Previous research has indicated that stigmatization constitutes a major obstacle to achieving the \"90-90-90\" targets\u003csup\u003e[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/sup\u003e. Specifically, it reduces the willingness of HIV-negative individuals to undergo HIV testing, hinders the effective linkage between PWHA and healthcare providers, and exerts a negative impact on patients' treatment adherence as well as viral load suppression outcomes.Additionally, the findings of Oryokot\u003csup\u003e[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/sup\u003e and Mukuku\u003csup\u003e[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/sup\u003e have shown that internalized family stigma, combined with external stigmatization and discrimination, prevents PWHA from achieving optimal viral suppression.\u003c/p\u003e \u003cp\u003eThis study found that higher self-efficacy was associated with better viral load suppression, similar to Umar\u003csup\u003e[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/sup\u003e. Self-efficacy is defined as an individual's perceived ability to adhere to HIV treatment regimens, including ART, and this ability is associated with better treatment adherence \u003csup\u003e[\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/sup\u003e. The prospective cohort observational study conducted by Spence\u003csup\u003e[\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e on women living with HIV showed that patients with higher HIV treatment self-efficacy were more likely to achieve viral suppression. The findings of Crockett\u003csup\u003e[\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/sup\u003e revealed that depressive symptoms in PWHA indirectly reduce their adherence to ART by diminishing self-efficacy, thereby leading to suboptimal viral suppression. Conversely, the study by Yigit\u003csup\u003e[\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/sup\u003e demonstrated that the alleviation of internalized stigma could indirectly improve both ART adherence and viral load suppression in PWHA through enhanced self-efficacy.\u003c/p\u003e \u003cp\u003eThis study demonstrates that adherence to ART is a protective factor for viral load suppression in PWHA, similar to Mukuku\u003csup\u003e[\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/sup\u003e. ART adherence is defined as strict compliance with the treatment regimen prescribed by healthcare providers, including taking the correct dosage of medication at the right time and in the proper manner\u003csup\u003e[\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/sup\u003e. PWHA often exhibit non-adherence to treatment due to reasons such as \"forgetting to take medication,\" \"failing to carry drugs when going out,\" \"being occupied with other matters,\" \"fearing disclosure of their condition when outside,\" or \"choosing to discontinue treatment after improvements in immune function\"\u003csup\u003e[\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/sup\u003e, and such non-adherence leads to viral load rebound\u003csup\u003e[\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/sup\u003e. A follow-up study conducted by Tchakoute\u003csup\u003e[\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/sup\u003e on PWHA in California, USA, demonstrated that ART adherence exerts an impact on both virological and immunological indicators: every 10% increase in adherence was associated with a 37% higher probability of viral suppression, as well as an average increase of 8.54 CD4 cells/\u0026micro;L within the subsequent six months. Additionally,A study by Glass\u003csup\u003e[\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/sup\u003e showed that self-reported missed doses of ART (two or more times) were associated with an increased risk of treatment failure and death. In contrast, research by Norcini-Pala\u003csup\u003e[\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/sup\u003e demonstrated that ART adherence may serve as a mediating factor\u0026mdash;intersecting stigma triggered by factors such as poverty, gender, and race could potentially increase the risk of unsuppressed viral load by contributing to poor ART adherence. Conversely, robust social support, high confidence in treatment, fewer ART-related side effects, and adequate nutrition can help patients achieve good treatment adherence, and consistent medication intake is conducive to achieving viral suppression\u003csup\u003e[\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn summary, among 369 PWHA in the XPCC region, 65 cases (17.62%) had a positive viral load, indicating that the current status of unsuppressed viral load still requires improvement. The study identified that CD4\u0026thinsp;+\u0026thinsp;T lymphocyte count\u0026thinsp;\u0026ge;\u0026thinsp;550 cells/\u0026micro;L, treatment duration\u0026thinsp;\u0026ge;\u0026thinsp;3 years, history of alcohol consumption, experience of discrimination, ART adherence, and self-efficacy are factors influencing unsuppressed viral load in PWHA. ART adherence is a key factor and can serve as a mediating factor that mediates the effects of social support, self-efficacy, and other factors on viral load.To facilitate the achievement of viral load suppression, targeted measures should include: strengthening precise clinical intervention for key patient groups, enhancing patients\u0026rsquo; ART adherence and self-efficacy through diverse approaches, and improving the social support system that combines anti-discrimination publicity with multi-dimensional support.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePWHA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003epatients with HIV/AIDS\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eXPCC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eXinjiang Production and Construction Corps\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHIV/AIDS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHuman immunodeficiency virus/acquired immunodeficiency syndrome\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHAART\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ehighly active antiretroviral therapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eART\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eantiretroviral therapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eUNAIDS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eJoint United Nations Program on HIV/AIDS\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eVCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eVoluntary Counseling and Testing\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eVL\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eviral load\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNNRTI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNon-Nucleoside Reverse Transcriptase Inhibitor\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNRTIs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNucleoside Reverse Transcriptase Inhibitors\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePIs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eProtease Inhibitors\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe certify that the study was conducted in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study protocol and the waiver of informed consent were approved by the Ethics Review Committee of the First Affiliated Hospital of Shihezi University (No.: KJ2023-311-01). Informed consent was obtained from all participants prior to the administration of the questionnaire.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Consent for publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Availability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe information of PWHA shall be strictly kept confidential.We will require all interested parties to provide the data request in writing. It shall require the approval of both the hospital and the local Center for Disease Control and Prevention (CDC).Once agreed to, data transfer agreements will be developed. All data transfers must comply with all applicable Zambian regulatory requirements.All data usage must comply with all applicable China`s regulatory requirements.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere are no relevant financial or non-financial conflicts of interest to declare\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e :\u003c/p\u003e\n\u003cp\u003eSupported by the Special Fund for Basic Scientific Research Operations of the Central-Level Public Welfare Research Institutes of the Chinese Academy of Medical Sciences(2020-PT330-003). Guided Science and Technology Program Projects of the Xinjiang Production and Construction Corps(2022ZD026).The Young and Middle - Aged Backbone Medical Talents Sub - project under the Medical and Health High - level Talents Program of the \"Tianshan Talents\" Initiative in the 3rd Batch of the \"2 + 5\" Key Talent Program(TSYC202401B078)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization: B·N, Y Du, W He and S Xie. Methodology: B·N, S Xie. Data curation and formal analysis: B·N. Writing—original draft: B·N, Y Du, W He. Writing—review and editing: W He, Y Du, S Xie, B·N.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eNational Center for AIDS/STD Control and Prevention, China CDC. 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Infect Dis Rep. 2021;13(1):126\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTchakoute T, Rhee C, Hare SY. Adherence to contemporary antiretroviral treatment regimens and impact on immunological and virologic outcomes in a US healthcare system. PLoS ONE. 2022;17(2):e0263742.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGlass TR, Sterne JA, Schneider MP, et al. Swiss HIV Cohort Study. Self-reported nonadherence to antiretroviral therapy as a predictor of viral failure and mortality. AIDS. 2015;29(16):2195\u0026ndash;200.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNorcini-Pala A, Stringer KL, Kempf MC, et al. Longitudinal associations between intersectional stigmas, antiretroviral therapy adherence, and viral load among women living with HIV using multidimensional latent transition item response analysis. Soc Sci Med. 2025;366:117643.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDaltro ACB, Almeida CS, Unfried AGC, et al. Virological failure and adherence to antiretroviral therapy in adolescents and young adults living with human immunodeficiency virus. Trop Med Int Health. 2023;28(3):162\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Acquired immunodeficiency syndrome, Viral Load Non-suppression, Mediation effects analysis, Risk factors","lastPublishedDoi":"10.21203/rs.3.rs-8188770/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8188770/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e \u003cp\u003e According to the Chinese Guidelines for the Diagnosis and Treatment of AIDS, virological indicators are critical for evaluating the effectiveness of antiretroviral therapy (ART). This study surveyed patients with HIV/AIDS (PWHA) on ART in the Xinjiang Production and Construction Corps(XPCC) to assess non-suppressed viral load and its influencing factors.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eClinical data and questionnaires were collected from 4 divisions of the XPCC using convenience sampling. Logistic regression and mediation models identified factors related to non-suppressed viral load.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong 369 PWHA, 65 (17.62%) had non-suppressed viral load. Influencing factors included CD4\u0026thinsp;+\u0026thinsp;T-cell count\u0026thinsp;\u0026ge;\u0026thinsp;500 cells/\u0026micro;L, treatment duration\u0026thinsp;\u0026ge;\u0026thinsp;3 years, alcohol consumption, discrimination, ART adherence, and social support (all P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). ART adherence played a full mediating role between self-efficacy, social support and viral load suppression in PWHA, with a mediation effect value (a*b) of -0.012 (95%CI: -0.552, -0.213) and \u0026minus;\u0026thinsp;0.026 (95%CI: -0.665, -0.389). Additionally, the \"social support \u0026rArr; medication adherence\" pathway exerted a partial chain mediating role between self-efficacy and viral load suppression in PWHA, with a mediation effect value (a*b) of -0.004 (95%CI: -0.244, -0.105).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eIn the XPCC, PWHA's viral load suppression rate hasn't met UNAIDS' \"95-95-95\" target. Priority should be given to PLWH with \u0026lt;\u0026thinsp;3 years of treatment and CD4\u0026thinsp;+\u0026thinsp;T-cell count\u0026thinsp;\u0026lt;\u0026thinsp;500 cells/\u0026micro;L. HIV-related education should be delivered to patients, families and the public to enhance social support and self-efficacy, reduce HIV-related stigma, and promote healthy lifestyles (e.g., reduced alcohol consumption). These measures will improve adherence to ART, thereby achieving effective viral load suppression.\u003c/p\u003e","manuscriptTitle":"Study on the current status and influencing factors of viral load non- suppression among patients with HIV and AIDS receiving antiretroviral therapy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-22 07:55:15","doi":"10.21203/rs.3.rs-8188770/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-11T08:29:41+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-10T12:30:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"286836295642120690381778017181142355835","date":"2026-03-09T01:19:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"50824978841457658645287934377874282609","date":"2026-03-08T16:31:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"233983427256008126998634816086814738826","date":"2026-03-05T16:20:09+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-26T17:54:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"116465888226116451986938058031014163789","date":"2026-02-12T14:48:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"74643708331469193976485519519935301643","date":"2026-02-11T01:48:32+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-01T16:24:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"334413269517588689505216958756414916024","date":"2026-01-13T00:52:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"238456661514652032342891252217898140804","date":"2026-01-12T12:08:41+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-05T16:04:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"66862195324315147502868324107102447206","date":"2025-12-22T23:51:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"219568159069242333676924199386539250872","date":"2025-12-21T13:23:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"136498670626176716944504778984578728310","date":"2025-12-20T03:50:32+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-18T14:53:59+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-18T11:09:30+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-08T04:08:48+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-07T06:13:15+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2025-12-07T06:07:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fad5a06b-7939-458f-958a-094c0abcd028","owner":[],"postedDate":"December 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-14T07:24:42+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-22 07:55:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8188770","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8188770","identity":"rs-8188770","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}