Background: Optimizing antiretroviral therapy is an essential step to reach the 90 -
90 - 90 targets. Despite tremendous progress made for antiretroviral treatment
(ART) to be accessible in countries with limited resources, health care
providers continue to face challenges due to the under-optimization of ART due
to therapeutic failures and poor retention. Objectives: To determine the
prevalence of adverse therapeutic outcomes in a decentralized health care center
and to determine associated factors. Patients and Methods: This is a
cross-sectional descriptive and analytical study targeting PLHIV, aged 18 years
and over, on first line antiretroviral treatment (ART), monitored onsite from
February 1st to December 31st, 2018. A data collection form was completed from
medical records (clinical, immuno-virological, therapeutic and evolutionary).
Data were also collected from interviews with patients for additional socio-demographic
information including the level of HIV knowledge. Data were captured and
analyzed using EPI 2002 and R software. Proportions were compared using the chi
-square and Fisher tests and logistic regression. A value of p < 0.05 was
considered significant. Results: 331 patients were enrolled with HIV-1
profile in 89% of the cases. A proportion of 55% was married and 98% came from
the rural area. 80% were either not or poorly educated. The median of age was
44 ± 11 years with a F/M ratio of 3.5. 30% that had not shared their HIV
status, and more than half had a low knowledge of HIV transmission. At
baseline, 56% were symptomatic at WHO stage 3 or 4. They had severe immunosuppression
with a median CD4 count of 217 ± 187 cells/mm3; the viral load was
detectable in half of the patients with a median viral load (VL) of 97,000 ± 70,
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