SynthesisPloS one2023
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 and meta-analysis.
Synthesis in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
50 citing papers in PubMed, 4 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Virologic failure and its determinants among HIV patients progress towards the third 95% global target in Ethiopia: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Pooled it
- Pooled it
- Characterizing the HIV care continuum among children and adolescents with HIV in eastern and southern Africa in the era of "Universal Test and Treat": A systematic review and meta-analysis.Journal of the International AIDS Society · 2025Pooled it
- The Acceptability of a Real-Time Medication Monitoring-Based Digital Adherence Tool Among Young People Living with HIV in Malawi.AIDS and behavior · 2026Trial
- Data-informed Stepped Care (DiSC) to improve adolescent and young adult HIV care outcomes in Kenya: a cluster randomized trial.Journal of the International AIDS Society · 2025Trial
- Trial
- A Moderated Mediation Model of HIV-Related Anticipated Stigma and Social Capital on the Relationship Between Diagnosis During the COVID-19 Pandemic and Potentially Problematic Substance Use Among Young South Africans.International journal of behavioral medicine · 2026Article
- Mobile Phone Access, Usage Patterns, and Perceptions of Adolescents Living With HIV on the Use of Gamified Interventions to Improve Antiretroviral Therapy Adherence in Eswatini: Qualitative Study.JMIR mHealth and uHealth · 2026Article
- Brief communication: clinical jaundice is associated with poor adherence to boosted atazanavir among adults in an HIV clinic in Kampala, Uganda.AIDS research and therapy · 2026Article
- Correlates of Viral Suppression in Adolescents With HIV Taking Antiretroviral Therapy in Mozambique: Results of a Multicenter Cross-Sectional Survey.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2026Article
- Estimates of global causes of death for children and adolescents aged 5-19 in 2000-24: secondary data analysis using bayesian multinomial logistic regression.BMJ (Clinical research ed.) · 2026Article
- Intersecting Vulnerabilities: Depression, Suicidality, and HIV Risk Among Young Mothers in South Africa.AIDS and behavior · 2026Article
- Prevalence and determinants of unmet sexual and reproductive health needs among adolescent girls and young women in the Haut-Sassandra Region, Côte d'Ivoire.Public health in practice (Oxford, England) · 2026Article
- Barriers to Antiretroviral Therapy Adherence Among Children in Ekurhuleni, South Africa: A Descriptive Study.International journal of environmental research and public health · 2026Article
- The relationship between self-reported adherence and virological outcomes among adolescents on antiretroviral therapy in Ghana.BMC public health · 2026Article
- Factors associated with antiretroviral therapy adherence among adolescents living with HIV in Addis Ababa, Ethiopia: structural equation modeling.AIDS research and therapy · 2026Article
- A synthesis of dimensions of wellbeing among adolescents and young people living with HIV from Sub-Saharan Africa for measurement in economic evaluation: a qualitative overview of reviews.Health and quality of life outcomes · 2026Review
- ART adherence care strategies among adolescents living with HIV in Ghana's Ashanti Region: a qualitative study.Frontiers in public health · 2026Article
- Demographic and Socioeconomic Factors Associated With ART Nonadherence Among 15 Years and Older South Africans. Evidence From the 2022 Cross-Sectional Population-Based Household Survey.AIDS research and treatment · 2026Article
Corrections and comments
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Authors and funding
4 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHuman Immunodeficiency Virus (HIV) significantly affects adolescents globally, with the sub-Saharan Africa (SSA) reporting a high burden of the disease. HIV testing, treatment, and retention to care are low among adolescents. We conducted a mixed-method systematic review to assess anti-retroviral therapy (ART) adherence; barriers and facilitators to ART adherence and ART outcomes among adolescents living with HIV and on ART in sub-Saharan Africa.
methodsWe conducted searches in four scientific databases for studies conducted between 2010 and March 2022 to identify relevant primary studies. Studies were screened against inclusion criteria and assessed for quality, and data was extracted. Meta-analysis of rates and odd ratios was used to plot the quantitative studies and meta-synthesis summarized the evidence from qualitative studies.
resultsA total of 10 431 studies were identified and screened against the inclusion/ exclusion criteria. Sixty-six studies met the inclusion criteria (41 quantitative, 16 qualitative, and 9 mixed-methods study designs). Fifty-three thousand two hundred and seventeen (53 217) adolescents (52 319 in quantitative studies and 899 in qualitative studies) were included in the review. Thirteen support focused interventions for improved ART adherence were identified from quantitative studies. The plotted results from the meta-analysis found an ART adherence rate of 65% (95%CI 56-74), viral load suppression was 55% (95%CI 46-64), un-suppressed viral load rate of 41% (95%CI 32-50), and loss to follow up of 17% (95%CI 10-24) among adolescents. Meta-synthesis found six themes of barriers to ART (social, patient-based, economic, health system-based, therapy-based, and cultural barriers) in both the qualitative and quantitative studies, and three themes of facilitators to ART were also identified (social support, counselling, and ART education and secrecy or confidentiality) from qualitative studies.
conclusionART adherence remains low among adolescents in SSA despite multiple interventions implemented to improve ART adherence. The low adherence rate may hinder the attainment of the UNAIDS 2030 targets. Additionally, various barriers to ART adherence due to lack of support have been reported among this age group. However, interventions aimed at improving social support, educating, and counselling adolescents may improve and sustain ART adherence.
trial registrationSystematic review registration: PROSPERO CRD42021284891.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.