Abstract
Introduction
Adherence to antiretroviral therapy (ART) is known to be challenging among adolescents living with HIV/AIDS, notwithstanding the life-saving importance of this therapy. Of the global total number of adolescents living with HIV in 2013, 83% reside in sub-Saharan Africa. The study aimed to identify facilitators of and barriers to antiretroviral treatment adherence among adolescents in Ghana.
Methods
A cross-sectional qualitative study using semi-structured interviews for data collection was carried out among adolescents (aged 12–19 years) at the adolescents HIV clinic at the Korle-Bu Teaching Hospital in Ghana. Predominantly open-ended questions relating to ART were used. Interviews were done until saturation. In total, 19 interviews were conducted. Analysis was done manually to maintain proximity with the text.
Findings
The main facilitators were support from health care providers, parental support, patient’s knowledge of disease and self-motivation, patient’s perceived positive outcomes, and dispensed formulation. The identified barriers were patient’s forgetfulness to take medicines, perceived stigmatization due to disclosure, financial barriers, and adverse effects of ART. Support from health care workers was the most frequently mentioned facilitator, and patient’s forgetfulness and perceived stigmatization after disclosure were the most frequently mentioned barriers. Self-motivation (knowledge induced) to adhere to treatment was a specific facilitator among older adolescents.
Conclusion
Continuous information provision in addition to unflinching support from health care workers and parents or guardians may improve adherence among adolescents. Also, interventions to reduce patient forgetfulness may be beneficial. A multi-sectorial approach would be needed to address adolescent disclosure of HIV/AIDS status.
Supplementary materials
Figure S1 Conceptual framework for adherence to ART among adolescents.
Abbreviation: ART, antiretroviral therapy.
Figure S2 Nature of questions asked (English).
Acknowledgments
The authors’ sincerest appreciation goes to Madam Elaine Awumee, Miss Mary Nordor, Miss Sabina Ansah, and all adherence counselors at the Korle-Bu Teaching Hospital for their invaluable assistance during patient selection and data collection for this study. The authors thank Rev Dr Albert Martins (the second coder) for finding time to assist.
Disclosure
The authors report no conflicts of interest in this work.