Factors Associated with HIV Viral Load Testing Uptake among Pregnant and Lactating Women in Iringa Municipal, Tanzania

Background: Vertical transmission of HIV in Tanzania and Iringa Municipal is still high with 11% HIV exposed infant born with HIV despite great effort done to reach elimination vertical transmission. This could be contributed by multiple factors; poor monitoring of HIV positive women is among the major contributing factor. There is currently a poor uptake of HIV viral load testing among pregnant and lactating women living with HIV compared to the general population getting HIV care and treatment despite efforts made by the World Health Organization (WHO).  Objectives: This study was aiming at determining the proportional and factors associated with HIV viral load testing among pregnant and lactating women living with HIV in Iringa Municipal.  Method and Materials: The Study design was facility based cross sectional in Iringa Municipal council. A total of 320 pregnant and lactating women who attended PMTCT services between 1st July and 31st July 2022 were interviewed. More information about client’s HIV viral load testing was extracted from clients’ cards and database. Descriptive statistic was done using frequency distributions, means/median, interquartile range while bivariable analysis was done by using logistic regression model to measure association of different variables with HIV viral load testing. All variables which had a p-value of less than 0.25 were subjected into multivariable analysis by using modified Poisson regression with robust standard error while adjusting for confounders.  Results: Out of 320 participants 163(50.9%) had HIV viral load tested within the past six months prior to the interview date. Pregnant and lactating women living with HIV who had understanding of when they are supposed to be tested for HIV viral load had 36% prevalence more to be tested for HIV viral load compared to those who do not understand. (aPR=1.358; p=0.015; 95%CI 1.065-1.737). Pregnant and lactating women living with HIV who receive PMTCT services from hospital and health center have 38% and 30% higher prevalence respectively for testing HIV viral load compared to those who receive at dispensary level. Hospital HVL testing (aPR=1.383; p=0.014; 95%CI=1.068 -1.79) and HVL testing at Health Center (aPR=1.299; p=0.047; 95%CI =1.004 -1.681).  Conclusion and Recommendation The proportional of HIV viral load testing among pregnant and lactating women (50.9%) found in this study is far below WHO recommendation. Predictive factor associated with low HIV viral load testing were clients understanding of when they are supposed to be testing for HIV viral load as well as level facilities. Tanzania Ministry of Health and Iringa Municipal council should consider identified factors to address low HIV viral load testing among HIV positive pregnant and breastfeeding women.