Social support is a critical factor in HIV treatment adherence and especially so for children living with HIV. This qualitative study from Tanzania, while small in sample size, did reveal some troubling findings regarding adherence support and barriers faced by adolescents and some distinct differences among maternal, paternal and double orphans.
All paternal orphans reported receiving treatment support while very limited support was received by maternal and double orphans. One-third of respondents–all maternal or double orphans–reported direct medication interference such as not allowing medicines to be refrigerated, not giving food to take with the treatment, or not allowing travel to get medication.
Medication interference, to our knowledge, has not been previously reported in the context of ART adherence in orphaned adolescents living with HIV, and these findings highlight the extreme challenges faced by some youth. Caregivers and household members appear to play a pivotal role in supporting or hindering medication use.