Barriers to antiretroviral therapy adherence for HIV-positive adolescents in South Africa

Background: The story of HIV in South Africa has been riddled with confusion and misinformation, claiming the lives of countless people. In 2014 HIV claimed the lives of over 140,000 people across the country. While the last 10 years have seen immense growth and improvement with regards to access to antiretroviral therapies (ART), new gaps in coverage have become apparent. We have entered an era in which children born HIV-positive are able to access treatment, and are likely to live through their teen years and beyond, but it is during this adolescent period that unique barriers threaten ART adherence efforts. Objective: This paper has two aims. Aim 1: Conduct a literature review of peer reviewed publications addressing barriers to ART adherence among HIV-positive adolescents in South Africa. Aim 2: Propose a pilot research project to improve ART adherence among adolescents seeking treatment in Khayelitsha, South Africa. Conclusion: There remains a notable gap in the literature with regards to data that determines and analyzes the barriers that HIV-positive adolescents on ART face within the context of South Africa. This paper seeks to fill the identified gaps and aims to summarize the important themes resulting from the literature search. In addition, it highlights potential barriers to adherence and outlines a pilot program to identify and address barriers for HIV-positive adolescents in Khayelitsha. Public Health Relevance: According to UNAIDS, if we address the issues of ART adherence within the adolescent population the current HIV/AIDS climate will change for the better. Increased adherence leads to lower and undetectable viral loads; lower viral loads then leads to a decreased likelihood of transmission, both horizontally and vertically. Ultimately, if greater adherence were to be achieved, there would be fewer people living with HIV and more people enabled to live longer, healthier and more productive lives