Antiretroviral Therapy and Retention in Care Experiences and Needs of Adolescents Living with HIV in Southern Ethiopia

HIV AIDS (Auckl). 2021 Nov 26:13:999-1007. doi: 10.2147/HIV.S339413. eCollection 2021.

Abstract

Background: Adolescents with HIV are faced with challenges when taking care of their medication, which affects their treatment adherence. Therefore, this study aimed to explore the experiences and needs of adolescents living with HIV regarding their antiretroviral therapy adherence and retention in care in southern Ethiopia.

Methods: An inductive qualitative study design was applied to explore adolescents' experiences and needs regarding antiretroviral treatment adherence and retention in care in southern Ethiopia. Eighteen adolescents were selected from five HIV care and treatment facilities by purposive sampling. The interviews followed an interview guide, translated into the participants' national language. The interviews were transcribed verbatim and the first author developed a coding frame for the analysis by using NVivo software including meaning units and codes, which were discussed by all authors. Then, sub-themes and themes were identified and analyzed by qualitative content analysis.

Results: The results were described in two themes: barriers and facilitators for treatment adherence and retention in care. Barriers were described in seven subthemes and facilitators in three subthemes. Forgetting to take medication, hiding information, or non-disclosure of HIV status, being afraid to collect treatment drugs, being in an orphanage, and school activities were described as barriers while support from health care workers, families, personal motivation to cope with medication-related problems were described as facilitators for antiretroviral therapy adherence and retention in care.

Conclusion: Adherence is a major challenge among adolescents living with HIV in Ethiopia, with barriers that are unique to this age group and their living conditions. Therefore, interventions should be targeted to address privacy barriers, stigma, and lack of support.

Keywords: HIV; adolescents; antiretroviral therapy adherence; disclosure; qualitative study; retention in care.

Grants and funding

The study was supported by the Swedish Research Council for Health, Working Life and Welfare Life (FORTE) (https://forte.se/en/) program support 2018–01399 and the Swedish Research Council (Vetenskapsrådet) (https://www.vr.se/english.html) program support VR 2016-05706. The funder had no role in the design of the study and collection, analysis, and interpretation of data or in writing the manuscript. The grant was awarded to IHK and DJ.