A Cross-Sectional Study on the Impact of Operation Triple Zero (OTZ) Program on Viral Load Suppression amongst Members of the Adolescent Club in 68 Nigerian Army Reference Hospital Yaba Lagos, Nigeria

Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national challenges with poor viral suppression. The OTZ program aligns with the UNAIDS 95-95-95 goals. It seeks to empower AYPLHIV to be in charge of their treatment and commit to triple zero outcomes—zero missed appointments, zero missed drugs, and zero viral loads. The purpose of the study was to assess the impact of the OTZ program on viral load suppression among members of the adolescent club in 68 NARHY, Lagos. Method: A cross-sectional retrospective study to evaluate the impact of the OTZ program on the viral load of 53 AYP enrolled in the OTZ program between March 2019 to December 2019 was analyzed. The Percentage of viral load suppression before enrollment compared with 6 and 12 months after enrollment into the OTZ program. The AYP is grouped into 10 - 14, 15 - 19, and 20 - 24 years. Activities conducted were peer driven monthly meetings with the AYP during which the adolescents interacted on issues relating to improving their treatment outcomes, healthcare workers reviewed their clinical status, viral load result, provider peer counseling, and caregivers’ engagement to support adherence to medication and ARV refills. Results: Before OTZ, 81% aged 10 - 14 years, 75% aged 15 - 19 years, and 25% aged 20 - 24 years were virally suppressed (VL less than 1000 copies/ml). Six months after enrollment, 94% were virally suppressed—95% aged 10 - 14 years, 96% aged 15 - 19 years, and 66% aged 20-24 years. Twelve months after enrollment, 96% of AYP were virally suppressed—100% aged 10-14 years, 93% aged 15 - 19 years, and 100% aged 20 - 24 years. Males’ viral load (VL) suppression improved from 79% to 96% and 92%, while females’ VL suppression improved from 69% to 93% and 100% at 6 and 12 months respectively. Conclusion: The OTZ activities contributed to improved viral load suppression in the AYP of the facility.