Navigating sociocultural practices and traditions in HIV management: a review of African cultural barriers to achieving sustainable development goal target 3.3

TL;DR

This review explores how African sociocultural beliefs affect HIV treatment and hinder progress toward a global health goal.

Contribution

The paper highlights the impact of pluralistic health-seeking behaviors on HIV care and proposes collaborative models to address cultural barriers.

Findings

Pluralistic health-seeking behaviors delay ART initiation and disrupt adherence.

Traditional and religious healing practices are influenced by perceived HIV causes and cultural beliefs.

Collaborative care models involving traditional and religious leaders are needed to improve HIV outcomes.

Abstract

The narrative review aimed to explore how the sociocultural belief systems influence the health-seeking behavior of individuals living with HIV (late ART initiation and treatment discontinuation) and the subsequent impact on SDG Target 3.3. We searched PubMed, using a search strategy using keywords such as “HIV management barriers,” “SDG Target 3.3,” and “sociocultural beliefs”, and it was adapted on Google Scholar, and AJOL between 1st may to 30th June 2025. Findings demonstrate that pluralistic health-seeking behavior, such as sequential use of biomedical care, religious healing, and traditional medicine, persists amongst individuals living with HIV. This is informed by society, religious, and traditional healers. The pluralistic health-seeking behavior is practiced based on what the individual perceives as the causes of HIV, the influence of religion and faith leaders, and traditional claims of HIV cure. Although pluralistic health-seeking behavior may offer emotional support, they associated with delayed initiation, disruptions, and adherence to ART, inadequate retention in care, and lower likelihood of long-term viral suppression, weakening the HIV care continuum. Although emerging research has explored the potential role of traditional medicine in HIV management, there is a lack of evidence to support its use as a standalone treatment. The findings of this review, emphasizes a need for a structured collaborative care models. Formal engagement and dialogue amongst traditional, religious leaders, and PHC practitioners’, development of referral linkages and integration of culturally sensitive HIV education within existing health systems at a policy level should be explored.

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