Barriers to anti-retroviral therapy adherence among adolescents aged 10 to 19 years living with HIV in sub-Saharan Africa: A mixed-methods systematic review protocol

Abstract

Background Antiretroviral therapy (ART) adherence is fundamental in achieving viral load suppression and consequently attaining positive health outcomes among people living with HIV. However, ART adherence is sub-optimum among adolescents living with HIV (ALHIV) thus the high AIDS-related mortality even after World Health Organization (WHO) revised HIV treatment eligibility guidelines in 2010, 2013 and 2016. Consolidated trends of barriers to ART adherence among ALHIV aged 10 to 19 years in sub-Saharan countries post each eligibility guidelines revision to date are unknown. Methods and analysis We will conduct comprehensive search of peer-reviewed and grey literature databases publishing observational studies reporting data adherence and barriers to ART among ALHIV on ART. We will further search the reference lists of included studies and other relevant reviews. We will also do a citation search for included studies in the review. We will search in the following databases PubMed, Cochrane Review, Scopus on Excerpta Medica Database (Embase) and Cumulated Index to Nursing and Allied Health Literature (CINAHL). Furthermore WHO, Joint United Nations Programme on HIV/AIDS (UNAIDS) websites, conference proceedings and country reports will be searched to identify relevant literature. Data will be extracted from eligible studies and synthesis will be through categorizing studies by year of study, barriers, and outcomes. Meta-analysis and meta-synthesis will be conducted for quantitative and qualitative data, respectively. Where meta-synthesis is impossible, narrative synthesis will be conducted. We will only include studies conducted between 2010 and 2022 within sub-Saharan Africa countries. Discussion Adherence to ART at a high level is required to achieve adequate viral suppression and improve quality of life in ALHIV. The knowledge of barriers to ART among ALHV may aid in the design of interventions aimed at improving ART adherence. Trail registration Systematic review protocol registration: PROSPERO CRD42021284891.

Barriers and facilitators to anti-retroviral therapy adherence among adolescents aged 10 to 19 years living with HIV in sub-Saharan Africa: A mixed-methods systematic review

“…However, the findings reported lower VLS rates compared to 2012 findings where VLS was at 84% in low-and middle-income countries yet was in consistent with findings of a systematic review reporting 59% in SSA [101,102] . Secondly, loss to follow up in our review was 17% (95% CI [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] which is lower to findings of a study conducted in 34 countries under the International epidemiology Database to Evaluate AIDS (IeDEA) where LTFU was reported to be 30% in 2018 [105]. Loss to follow up rate in this review indicate improvement when compared to studies conducted in 2007 in SSA where LTFU was 51% [106].…”

“…The systematic review is registered with PROSPERO (Registration: CRD42021284891) [22]. The results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA statement) [23], and the Enhancing Transparency in Reporting the synthesis of Qualitative research (ENTREQ) recommendations [24].…”

Telesupervision in Psychotherapy: A Bibliometric and Systematic Review

“…In addition, it complemented and enriched its analysis based on articles published in journals indexed in the JCR-WoS, with three articles on the same topic that were already included in a previous review that did not consider the first bibliometric technique indicated in the present methodological design. In this way, it was possible to incorporate six articles that covered five original empirical studies on telesupervision and that were evaluated with a tool (MMAT) that has been applied in several reviews related to health and mental health [ 72 , 73 , 74 ] among others.…”

“Swallowing these drugs every day, you get tired”: a mixed-methods study to identify Barriers and facilitators to retention and HIV Viral Load suppression among the Adolescents living with HIV in TASO Mbale and TASO Soroti centers of excellence

“…Furthermore, The Joint United Nations Program Against HIV/AIDS (UNAIDS) estimates, indicated that the global VLS in the sub-population was at 46% during the same year. A recent systematic review in SSA, reported a 55% VLS among the ALHIV and 65% adherence [4]. Similarly, In Uganda,.…”

“…Barriers to optimal VLS identi ed include; di culties nding transport money, unfriendly health settings, drug stock outs, prolonged waiting time, unfavorable school timetable, non-disclosure of HIV status and drug side effects [4][5][6][7][8][9][10]. Conversely, identi ed enablers include reliable stock-levels of drugs in the facilities, good attitude of health-workers, availability of transport money, social/family support, and positive peer in uence [4,7,8]. To counteract the barriers while enhancing the enablers, interventions implemented in different settings across Uganda.…”