Navigating viral load information flow and provider decision-making for adolescent clients at HIV clinics in Kenya

Achieving viral suppression goals for adolescents with HIV requires multifaceted strategies, including efficient and effective health systems to routinely monitor HIV viral load (VL) and support adolescents when adherence falters.

This study aimed to identify where gaps in information flow occur in return of HIV VL results to clinics and adolescents and to explore how providers determine 'good adherence' prior to confirmation of virological failure.

Four focus group discussions and ten in-depth interviews were conducted with purposively selected healthcare workers (n = 39) from various phases of VL information flow. We used thematic analysis to identify themes.

Themes consisted of individual- and family-level challenges, facility-level barriers, supply chain constraints affecting laboratory-related delays, client-specific factors impacting dissemination of VL results, reluctance to repeat VL until adherence challenges are resolved.

The identified themes highlighted that individual, social, and health systems factors were perceived as contributing to success or delay in the ability to obtain timely VL results and repeat confirmatory VL testing.