Adherence to antiretroviral therapy among HIV-1 patients from sub-Saharan Africa: a systematic review

AIDS Rev. 2024;26(3):102-110. doi: 10.24875/AIDSRev.24000004.

Abstract

More than two decades after introducing antiretroviral therapy (ART), several challenges still prevail in keeping well people living with HIV, even with "Test and Treat" and/or "Rapid Start of ART" initiatives, as well as the scale-up of ART worldwide to promote access and adherence to treatment. This review examined articles on ART adherence in Africa between 2016 and 2023, published in English and indexed in PubMed. A total of 16 articles out of 2415 were eligible and included for analyses. Overall, good ART adherence rates in sub-Saharan African (SSA) regions ranged from 43% to 84%. Rates in the center of the SSA region ranged from 58% to 80%, in the north from 50% to 83%, in the south from 77% to 84%, in the west from 43% to 60%, and in the east from 69% to 73%. Most African countries use self-reporting to assess treatment adherence, which is frequently unreliable. The main factors with negative influence on ART adherence were comorbidities, lack of motivation, socioeconomic difficulties, or side effects. Conclusion: Adherence to ART is a good indicator for controlling the spread of HIV in a given region. It is important to overcome the barriers that make it difficult to comply with ART and reinforce the factors that facilitate access to medication.

Keywords: Antiretroviral therapy; HIV-1; Sub-Saharan Africa; Treatment adherence.

Publication types

  • Systematic Review

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Anti-HIV Agents / therapeutic use
  • Anti-Retroviral Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active
  • HIV Infections* / drug therapy
  • HIV-1*
  • Humans
  • Medication Adherence* / statistics & numerical data

Substances

  • Anti-HIV Agents
  • Anti-Retroviral Agents