Antiretroviral treatment adherence in South Africa : an adolescent perspective.

Abstract

The introduction of Antiretroviral (ARV) treatment has allowed for many children living with human immunodeficiency virus (HIV) to survive to adolescence. However for this to be a reality adherence to treatment is important. Many studies suggest that during adolescence adherence can be very challenging. However not much research has been done within the South African context to understand what HIV positive adolescents are experiencing, particularly in relation to ARV adherence. The aim of this research study was to explore the experiences of adolescents on antiretroviral therapy (ART) in order to understand what helps them to adhere to their medication and the challenges that they may have with adherence. This was achieved by carrying out 5 semi-structured in-depth interviews with HIV positive adolescents on ARVS at a shelter for HIV positive women and children in Johannesburg. A thematic content analysis was used to analyse the transcribed interviews. The results indicated several factors that both assist with adherence and those that challenge adherence. The participants reflected on the importance of full disclosure which increases their understanding of the importance of adherence, having people they trust whom they can confide in and who also support them to take and adhere to the ARVs, and having a positive experience at the hospital when they go for their regular checkups. Certain defence mechanisms adopted by the adolescents to help them cope with living with HIV and having to take medication every single day of their lives were also identified. The fact that acceptance is a process was also suggested by the research findings. The challenges the adolescents face were those of stigma and a fear of being rejected, bad experiences associated with taking medication, such as the negative side effects and the disruption of their leisure time, and negative experiences from going to the hospital. This study yielded some rich information that may aid in understanding what adolescents are experiencing and facing which may inform future research studies on this topic and policies which may assist with an increase in adherence.