Abstract: Introduction Treatment failure among youth aged 10–24 years receiving antiretroviral therapy (ART) remains a critical challenge to achieving the UNAIDS 95-95-95 targets in sub-Saharan Africa. In Rwanda, where HIV prevalence is approximately 3.0% nationally, adolescents and young adults face disproportionate adherence barriers and poorer treatment outcomes relative to older adults. Evidence on the magnitude and determinants of ART failure in this age group from decentralized Rwandan facilities is limited. This study aimed to quantify the prevalence and identify socio-demographic and clinical determinants of treatment failure among youth on ART at Rwamagana Level Two Teaching Hospital. Methods We conducted a retrospective cross-sectional study using secondary data extracted from 385 medical records of youth aged 10–24 years enrolled in HIV care and on ART for at least 12 months at Rwamagana Level Two Teaching Hospital, Rwanda (March–June 2024). Treatment failure was defined according to WHO 2023 criteria and classified as virological (viral load ≥1,000 copies/mL on two consecutive measurements following enhanced adherence counselling), immunological, or clinical failure. Socio-demographic and clinical variables were extracted using a structured data abstraction form. Data were analyzed using SPSS v26.0; descriptive statistics, chi-square tests, and multivariable logistic regression were performed. This study adheres to STROBE reporting guidelines. Results : Of 385 youth (53.8% female; median age group 20–24 years), 97 (25.2%) experienced treatment failure. Virological failure predominated (62.9%), followed by immunological (23.7%) and clinical (13.4%) failure. In the multivariable model, older youth aged 20–24 years had more than double the odds of treatment failure compared with those aged 10–14 years (AOR = 2.1; 95% CI: 1.2–3.8; p = 0.009). Female sex (AOR = 1.6; 95% CI: 1.0–2.6; p = 0.047), advanced WHO clinical stage III–IV (AOR = 3.8; 95% CI: 2.1–6.9; p < 0.001), presence of opportunistic infections (AOR = 2.2; 95% CI: 1.3–3.9; p = 0.004), and ART duration exceeding five years (AOR = 2.4; 95% CI: 1.3–4.1; p = 0.002) were independently associated with treatment failure. Conclusions: One in four youth on ART at Rwamagana Level Two Teaching Hospital experienced treatment failure, predominantly virological. Clinical disease burden, older adolescent age, female sex, and long ART duration are key risk factors. Targeted interventions including intensified viral load monitoring, gender-responsive adherence support, and early initiation of ART are urgently required. These findings inform national strategies for adolescent and youth-friendly HIV services in Rwanda and comparable settings.
Keywords: HIV; antiretroviral therapy; treatment failure; virological failure; adolescents; youth; Rwanda; sub-Saharan Africa.
Title: TREATMENT FAILURE AMONG YOUTH AGED 10-24 YEARS ON ANTIRETROVIRAL THERAPY ATA LEVEL TWO TEACHING HOSPITAL IN RWANDA
Author: Mbonigaba Youssouf, Japheths Ogendi, Monica Mochama
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
Vol. 14, Issue 1, April 2026 - September 2026
Page No: 519-526
Research Publish Journals
Website: www.researchpublish.com
Published Date: 04-August-2026
