A qualitative analysis of family support for adolescent HIV care in South Africa

ABSTRACT

Compared to other age groups, South African adolescents living with HIV (ALWH) have the lowest rates of retention in HIV care and medication adherence. While previous research suggests that familial social support may improve treatment retention and adherence within this population, we know little about the influence of differential types of social support on HIV-related outcomes. Thus, the purpose of this study is to qualitatively characterize the influence of type of familial social support on treatment retention and adherence among ALWH. We interviewed adolescents living with perinatally-acquired HIV (n = 20), their caregivers (n = 19), and community stakeholders (n = 20) in Cape Town, South Africa. Data were coded using deductive and inductive approaches to content analysis. We identified four types of familial social support: instrumental, appraisal, emotional, and informational support. Families provided instrumental support through logistical assistance, including transportation to appointments and pill reminders. Families also provided both emotional support and appraisal support, encouraging ALWH to adhere to their medication regimens by reflecting upon its importance to their futures. For informational support, families often educated ALWH about their HIV status and strategies for disease self-management. In characterizing familial social support, our findings highlight potential targets of future interventions to improve HIV-related outcomes among ALWH.

KEYWORDS:

• Adolescents living with HIV
• family
• social support
• HIV care
• South Africa

Acknowledgements

We would like to thank the adolescents, caregivers, and stakeholders who took part in this study. We would also like the acknowledge the contributions of our research assistants, Asantewa Oduro and Noluthando Ntlapo, for their participation in data collection. We also thank the Desmond Tutu HIV Centre for their support of this work.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Researchers interested in data from this study are encouraged to contact the principal investigator, TR.

Additional information

Funding

TR’s effort was supported by career development awards from the Duke Center for Research to Advance Healthcare Equity (REACH Equity), which is supported by the National Institute on Minority Health and Health Disparities under award number U54MD012530 and the National Institute of  Mental Health (K08MH118965). Other support was provided by means of training grants from the National Institute on Drug Abuse (R25DA035692) and the UJMT Global Consortium (D43TW009340), and faculty development funds from the Duke University Center for AIDS Research (CFAR), an NIH funded program (5P30AI064518). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.