Why do some teens living with HIV adhere well to their medication regimens, and others do not? The authors conducted focus group discussions and interviewed adolescents at both ends of that spectrum in Botswana, seeking to determine which factors most commonly pose barriers and which most often facilitate good adherence.
The study team coded the transcripts, then developed matrices to classify how individuals with different adherence characteristics generated different themes.
Interference with daily activities, concerns about stigma and discrimination, side effects, denial of HIV status, and food insecurity arose across the board as challenges to adherence--among both consistently adherent and poorly adherent teens. What distinguished the poorly adherent teens and their caregivers was lower outcome expectancy, treatment fatigue, mental-health and substance-use problems, and mismatches between the social supports the teens wanted and those they received. These latter challenges may be the more important factors that can make or break teens' HIV medication adherence.
Read the study in AIDS Care.