Final Thesis

This research examines the multilevel determinants influencing viral load suppression among adults receiving antiretroviral therapy in Plateau State, Nigeria, from 2019 to 2024. Using secondary data from 7,029 patients across 35 treatment sites, the study employs a mixed-effects logistic regression model to identify factors associated with treatment success. Results reveal a high overall suppression rate of 93.6%, but with a widening gap in baseline viral suppression, particularly among vulnerable subgroups such as uneducated or unmarried patients. The analysis indicates that clinical factors like high initial viral loads, as well as social determinants like education level and marital status, significantly influence outcomes. Importantly, facility-level variables, such as geographic location, were less predictive once individual vulnerabilities were accounted for. Recommendations emphasize targeted support for high-risk groups and strengthening facility capacity to sustain epidemic control.