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dc.contributor.authorAmmon, Nadine
dc.contributor.authorMason, Susanna
dc.contributor.authorCorkery, John
dc.date.accessioned2018-12-21T01:14:09Z
dc.date.available2018-12-21T01:14:09Z
dc.date.issued2018-04-01
dc.identifier.citationAmmon , N , Mason , S & Corkery , J 2018 , ' Factors impacting antiretroviral therapy adherence among human immunodeficiency virus-positive adolescents in Sub-Saharan Africa: a systematic review ' , Public Health , vol. 157 , pp. 20-31 . https://doi.org/10.1016/j.puhe.2017.12.010
dc.identifier.issn0033-3506
dc.identifier.otherPURE: 13067592
dc.identifier.otherPURE UUID: a6c9203f-2845-4a8c-bbd3-eb092653c85e
dc.identifier.otherScopus: 85042645822
dc.identifier.urihttp://hdl.handle.net/2299/20890
dc.description© 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
dc.description.abstractObjectives: Eighty-two percent of human immunodeficiency virus (HIV)–positive adolescents live in Sub-Saharan Africa (SSA). Despite the availability of antiretroviral therapy (ART), adherence levels are suboptimal, leading to poor outcomes. This systematic review investigated factors impacting ART adherence among adolescents in SSA, including religious beliefs and intimate relationships. Methods: A systematic review was conducted between June and August 2016 using eight electronic databases, including Cochrane and PubMed. Published, ongoing and unpublished research, conducted in SSA from 2004 to 2016, was identified and thematic analysis was used to summarise findings. Results: Eleven studies from eight SSA countries, published in English between 2011 and 2016, reported on factors impacting ART adherence among adolescents living with HIV (ALHIV). Forty-four barriers and 29 facilitators to adherence were identified, representing a complex web of factors. The main barriers were stigma, ART side-effects, lack of assistance and forgetfulness. Facilitators included caregiver support, peer support groups and knowledge of HIV status. Conclusions: Stigma reflects difficult relations between ALHIV and their HIV-negative peers and adults. Most interventions target only those with HIV, suggesting a policy shift towards the wider community could be beneficial. Recommendations include engaging religious leaders and schools to change negative societal attitudes. Limitations of the review include the urban settings and recruitment of predominantly vertically infected participants in most included studies. Therefore, the findings cannot be extrapolated to ALHIV residing in rural locations or horizontally infected ALHIV, highlighting the need for further research in those areas.en
dc.format.extent12
dc.language.isoeng
dc.relation.ispartofPublic Health
dc.rights/dk/atira/pure/core/openaccesspermission/embargoed
dc.subjectAdherence
dc.subjectAdolescents
dc.subjectAntiretroviral therapy
dc.subjectHIV
dc.subjectSub-Saharan Africa
dc.subjectPublic Health, Environmental and Occupational Health
dc.titleFactors impacting antiretroviral therapy adherence among human immunodeficiency virus-positive adolescents in Sub-Saharan Africa: a systematic reviewen
dc.contributor.institutionDepartment of Pharmacy, Pharmacology and Postgraduate Medicine
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionCentre for Clinical Practice, Safe Medicines and Drug Misuse Research
dc.contributor.institutionDepartment of Clinical and Pharmaceutical Sciences
dc.description.statusPeer reviewed
dc.date.embargoedUntil2019-03-20
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85042645822&partnerID=8YFLogxK
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Accepted Version
dcterms.dateAccepted2017-12-18
rioxxterms.versionAM
rioxxterms.versionofrecordhttps://doi.org/10.1016/j.puhe.2017.12.010
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
rioxxterms.licenseref.startdate2019-03-20Z
rioxxterms.typeOther
herts.preservation.rarelyaccessedtrue
herts.date.embargo2019-03-20Z
herts.rights.accesstypeopenAccess


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