Social determinants of adherence to antiretroviral therapy among adolescents and young people living with HIV: a scoping review.
Camila Moraes Garollo Piran, Mariana Martire Mori, Alana Vitória Escritori Cargnin and 5 others
PMID 40844409WHAT IT FOUND
Adolescents with HIV adhere to treatment when they understand it, have stable routines, and receive family or peer support.
Barriers include stigma, fear of disclosure, depression, forgetfulness, and distance to clinics. Adherence is not just about motivation.
Key findings
01Factors influencing adherence are organized into five dimensions: individual characteristics, lifestyle, social networks, living/health conditions, and socioeconomic/cultural conditions.
02Promoters of adherence include health literacy, self-efficacy, family support, and access to services, while barriers include forgetfulness, depression, stigma, and poverty.
03Most included studies used self-reported adherence measures, which may introduce bias compared to physiological or pharmacological methods.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included studies with diverse adherence measurement methods, mostly self-report, which introduces bias and makes direct comparison difficult. The authors note that the methodological heterogeneity and different epidemiological contexts prevent generalizing the data. Only one included study examined the perspective of family caregivers, limiting understanding of the family dynamic. The search may have missed relevant studies due to the exclusion of some indexing databases.
Declared interests
The work was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) in Brazil, Funding Code 001. No other conflicts of interest are reported.
The easy way to misread this
Do not interpret the identified factors as proven causes of adherence. This is a scoping review mapping existing evidence, not a meta-analysis establishing effect sizes. The association between factors like stigma or poverty and adherence is complex and varies by context, and most evidence relies on self-reported adherence which may be inaccurate.