Psychosocial support systems for adolescents on antiretroviral therapy in rural western Kenya

Abstract

Initiation of antiretroviral therapy (ART) was a major milestone in the care and management of HIV; however, adolescents who are living with HIV (ALHIV), and who are on ART still show a 50% increase in deaths due to sub-optimal adherence. Despite reduced therapeutic options and higher risk of repeated treatment failure, there was a dearth of information which was focusing on adherence support. This paper was conducted to explore how existing psychosocial support systems promoted adherence among 15-19years old ALHIV on 2nd-line ART. Using focused ethnographic design, data was collected from 37 ALHIV enrolled in the sampled patient support centers. Data was collected by using semi-structured interviews, direct observation, 10 in-depth and 13 key informant interviews and 3 focus group discussions. Social ecological theory was used to explore the interplay between available resources, health habits and life-styles of the respondents. Data from semi-structured interviews were cross-tabulated to identify appropriate relationships. Qualitative data were exposed to thematic analysis, and they were presented using descriptions and verbatim quotations. According to the findings of the study, psychosocial support systems were essential in promoting adherence among ALHIV. The researchers recommended that treatment guidelines and intervention strategies should recognize the central role of psychosocial support from families, and from the healthcare setting, and it promotes their participation in care and management of HIV among ALHIV.