A Scoping Review of Viral Suppression Rates Among Incarcerated Women Living with HIV Accessing Onsite Antiretroviral Therapy in Kigali, Rwanda

Incarcerated women living with HIV are a vulnerable group with complex health needs. Consistent access to antiretroviral therapy (ART) is essential for viral suppression, but evidence on treatment outcomes in prison settings, especially in sub-Saharan Africa, remains scarce. This review examines the specific context of onsite ART provision in a female prison in Kigali, Rwanda. This scoping review aimed to map and synthesise existing evidence on viral suppression rates among incarcerated women living with HIV accessing onsite ART at the female prison in Kigali, Rwanda. Its objective was to ascertain reported rates and identify factors influencing treatment outcomes. A scoping review was conducted using established methodological frameworks. A systematic search was performed across relevant electronic databases. Grey literature and organisational reports were also screened. Included materials described viral load outcomes for the specified population. Data were extracted and analysed thematically. The review revealed a significant lack of peer-reviewed literature specifically reporting viral suppression rates for this population. Available programme data and grey literature indicate that onsite ART provision can support engagement in care. A key theme was the importance of integrated, prison-based health services for supporting adherence. However, a consolidated, aggregate viral suppression rate could not be determined from the fragmented evidence base. There is a pronounced deficiency in published, quantitative data on viral suppression rates for incarcerated women accessing ART in this setting. While onsite service delivery is perceived as beneficial, the lack of consolidated outcome data obstructs a clear assessment of treatment effectiveness and hinders evidence-based programme enhancement. Future research should prioritise robust reporting of clinical outcomes for this marginalised population. Standardised monitoring of viral load outcomes within prison health programmes is urgently required. Investment in operational research to identify optimal service delivery models is also recommended. HIV, viral suppression, incarcerated women, antiretroviral therapy, prison health, Rwanda, scoping review. This review consolidates the current state of evidence on a critically under-researched topic, highlighting a major evidence gap and outlining necessary steps for improving health outcomes and monitoring for incarcerated women living with HIV in Rwanda.