# Perceptions of adolescents and young adults failing antiretroviral therapy on adherence in Gauteng, South Africa

## TL;DR

This study explores why adolescents and young adults in South Africa struggle to stick to HIV treatment, highlighting issues like stigma, healthcare access, and side effects.

## Contribution

The study provides new insights into the personal and systemic barriers affecting ART adherence among adolescents and young adults in Gauteng, South Africa.

## Key findings

- AYAs face challenges like stigma and disclosure complexities that lead to intentional treatment cessation.
- Healthcare facility issues, such as limited counseling and appointment difficulties, hinder ART adherence.
- Personal expectations of an HIV cure and side effects also contribute to poor adherence.

## Abstract

The management of HIV among adolescents and young adults (AYAs) living with HIV is often complicated by systemic barriers within healthcare services, particularly communication challenges, inadequate support systems, and other external factors. Understanding these barriers is essential for improving antiretroviral therapy (ART) adherence and overall health outcomes in this population.

The study aimed to examine and describe the perceptions of AYAs living with HIV on treatment adherence.

A qualitative approach was applied using semi-structured interviews with AYAs aged 18–24 living with HIV. Twenty AYAs living with both perinatal and horizontally acquired HIV, from four healthcare facilities in Sedibeng District in Gauteng province, with two consecutive viral load results of above 1000 copies/mL identified using the TIER.NET patient management system, were purposively selected and interviewed. Thematic analysis was conducted.

The review identified five key themes characterising the challenges with ART adherence for AYAs. These themes include personal expectations regarding the possibility of HIV cure, and discomfort from side effects, intentional treatment cessation emanating from stigma and disclosure complexities, and healthcare facility challenges, including facility appointments and limited counselling.

The study highlights the need for early identification of barriers to adherence. This should include implementing strategies to enhance accessibility of counselling, and other services to improve adherence and overall wellbeing of AYAs living with HIV.