Background: The attainment of viral suppression (VS) has not only extended the life expectancy of HIV-infected pregnant women (HIPW) but also has significantly reduced the rate of HIV vertical HIV transmission (VT). We to ascertain the rate of VS among HIPW at health facilities.

Methods: A retrospective cohort study was carried out from June 1, 2016, to May 31, 2024. Data were extracted via document review using a structured and pretested checklist.

Results: The overall VS rate was 392 (93.60%). Poor adherence to ART and a CD4 cell count of 350 or fewer were associated with a decreased likelihood of achieving VS. The odds of poor adherence to ART and a CD4 cell count of 350 or fewer were both 0.1 at 6 months after initiating ART (adjusted odds ratio [aOR] 0.1, 95% confidence interval [CI] 0.2-0.2) and (aOR 0.1, 95% CI 0.1-0.3), respectively. Employment increased the odds of VS in women by 4.1 times (aOR 4.1, 95% CI 1.1-14.9) at 6 months after ART initiation compared to being a housewife.

Conclusion: The VS rates observed in the study facilities are promising but remain significantly below the targets set for achieving epidemic control. Therefore, intensified efforts are crucial to attain the goal of HIV epidemic control.