Antiretroviral Therapy Adherence in HIV-Positive Adolescents

Adolescents living with HIV face a unique constellation of developmental, psychosocial and structural challenges that can undermine consistent uptake of antiretroviral therapy (ART). Rapid cognitive and emotional maturation coincides with increasing demands for autonomy, rendering routine medication schedules vulnerable to disruption. Stigma, disclosure anxieties and mental‐health burdens often combine with practical barriers—such as limited clinic accessibility, school commitments and weak social support networks—to depress adherence and compromise long-term virological suppression. Sustained adherence in this age group is critical to prevent drug resistance, ensure durable immune recovery and curb onward transmission. Recent advances have emphasised multilevel interventions that integrate life-stage assessment, peer support and patient-centred, differentiated service delivery. Complementary approaches harness mobile and digital technologies to provide reminders, adherence monitoring and tailored counselling. A holistic understanding of adherence in adolescents must account for individual behavioural drivers, family and community dynamics, and health-system factors. Effective strategies demonstrate that flexible clinic access, rapid viral-load feedback and empowerment through peer educators can bring adolescents closer to global targets for treatment coverage and viral suppression, thereby reinforcing the broader goals of epidemic control and equity in HIV care.

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Antiretroviral Therapy Adherence in HIV-Positive Adolescents publication trend

The graph below shows the total number of articles in antiretroviral therapy adherence in hiv-positive adolescents across all publications each year (not limited to Nature Index journals).

Technical terms

Adherence: The extent to which a patient’s ART intake corresponds to agreed recommendations, critical for viral suppression and prevention of resistance.

Virological suppression: Reduction of HIV RNA in blood plasma to below detectable levels, the primary goal of successful ART.

Differentiated service delivery: Tailored models of care that adjust location, frequency and type of services to meet individual needs and preferences.

Peer educator: A trained individual living with HIV who provides psychosocial support, adherence counselling and linkage to services among peers.

mHealth (mobile health): Use of mobile devices and digital technologies to deliver health information, reminders and adherence support.

References

1. A multilevel health system intervention for virological suppression in adolescents and young adults living with HIV in rural Kenya and Uganda (SEARCH-Youth): a cluster randomised trial. The Lancet HIV (2023).
2. Effectiveness of a peer educator-coordinated preference-based differentiated service delivery model on viral suppression among young people living with HIV in Lesotho: The PEBRA cluster-randomized trial. PLOS Medicine (2023).
3. Effectiveness, Acceptability and Feasibility of Technology-Enabled Health Interventions for Adolescents Living with HIV in Low- and Middle-Income Countries: A Systematic Review. International Journal of Environmental Research and Public Health (2023).