Faculty Collaboration Database

"She tells me the HIV is eating my brains": barriers and facilitators to antiretroviral therapy adherence among Eswatini adolescents living with HIV. AIDS Care 2025 Feb;37(2):310-323

Date

01/20/2025

Pubmed ID

39831528

DOI

10.1080/09540121.2024.2443677

Scopus ID

2-s2.0-85213522502 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

Despite the successful rollout of antiretroviral therapy (ART) and positive ART outcomes in the Kingdom of Eswatini, adolescents still present poor ART outcomes including low viral load suppression and suboptimal ART adherence. The aim of the study was to explore the perceptions of adolescents living with HIV (ALHIV) on the barriers and facilitators to ART adherence in Eswatini. We conducted a qualitative study using in-depth interviews among 29 ALHIV and on ART in Eswatini in December 2023. Adolescents aged 10-19 years who were aware of their HIV status were recruited purposively from five Teen Clubs in the Hhohho region. Six barriers to ART were reported by participants namely perceived stigma and discrimination, competing demands between ART schedules and their personal and social lives, medication issues, health facility factors, lack of transport and food, and diminishing support from caregivers. The main facilitators of ART adherence were having a social support system, status disclosure, privacy, HIV and ART knowledge, and motivation to stay alive. Supportive environments are crucial to enhance ART adherence among ALHIV. These can be promoted through multi-component interventions that target status disclosure, increase knowledge of HIV and ART, ensure privacy and address stigma and discrimination.

Author List

Hlophe LD, Nyasulu PS, Shumba CS

Author

Constance S. Shumba PhD Associate Professor in the Institute for Health and Humanity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Anti-HIV Agents
Anti-Retroviral Agents
Child
Female
HIV Infections
Health Knowledge, Attitudes, Practice
Humans
Interviews as Topic
Male
Medication Adherence
Qualitative Research
Social Stigma
Social Support
Young Adult