‘Now that you have eaten, it is time for drugs’: Adherence Support Systems among Adolescents on Second-line Antiretroviral Therapy in Rural Western Kenya
Keywords:
ALHIV on second-line ART; Psychosocial; Support; Reminder tools; Adherence.Abstract
The initiation of antiretroviral therapy (ART) was a significant milestone in the care and management of HIV;
however, adolescents living with HIV (ALHIV) on ART were the only sub-population that registered a 50%
increase in deaths after initiating ART due to sub-optimal adherence. Despite reduced therapeutic options,
higher risk of repeated treatment failure, and the cost implications for the healthcare system, there needed
to be more information focusing on optimal adherence support. This study explored how existing
psychosocial support systems promoted adherence among 15-19-year-old ALHIV. The study used social
ecological theory to explore the interplay between available resources, health habits, and respondents'
lifestyles. Focused ethnography was employed to collect data from 37 ALHIV on 2nd-line ART. The study
administered 37 semi-structured questionnaires, used direct observation, conducted ten in-depth and 13 key
informant interviews, and held 3 focused group discussions. Quantitative data were analyzed using
descriptive statistics with the aid of SPSS version 20 and presented in tables of frequencies and
percentages. Qualitative data was exposed to thematic analysis and presented using descriptions and
verbatim quotations. The study findings showed that psychosocial support systems were vital in promoting
adherence among ALHIV on ART.
