Introduction:
Education and disease management have resulted in global decline of new HIV infections, from 2.8 million a year in 2000 to about 1.5 million in 2020 (46% reduction) as well as number of deaths, from 1.4 million in 2000 to 690,000 a year in 2020 (51% reduction). The purpose of this study was to examine factors associated with viral load (VL) suppression (< 1,000 copies/ml), including age, sex, and geographic and clinical characteristics of patients on antiretroviral therapy (ART) in outpatient clinics in Kinshasa and Haut-Katanga Provinces, Democratic Republic of Congo (DRC).

Material and methods:
Using a retrospective cohort study design, we analyzed data of 5,338 people living with HIV (PLHIV) on ART from 116 HIV/AIDS clinics located in the Haut-Katanga and Kinshasa Provinces in DRC. 2 and multivariable logistic regression analyses were applied.

Results:
Age and urban health zones were significantly associated with VL suppression. Eighty-six percent of adult patients (15 years or older) had achieved a VL suppression, compared to 73.5% of patients younger than 15 years. Average time on ART was less than three years, and majority of participants were 15 years of age or older, females, and mostly living in urban areas.

Conclusions:
Our findings indicated that younger patients on ART and patients living in semi-rural areas (vs. urban) had a significantly lower probability of risk of VL suppression, underscoring the need for enhanced efforts targeting these populations.