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Member Research & Reports

Member Research & Reports

Brown: HIV+ Adolescents in Brazil Face Multiple Individual and Structural Barriers to ART Adherence

Researchers at the Brown University School of Public Health have recently published a qualitative study investigating barriers to antiretroviral therapy (ART) adherence among human immunodeficiency virus (HIV) positive individuals in Brazil. The study, lead by Dr. Katie Biello, an associate professor of behavioral and social sciences at the Brown University School of Public Health, was published in AIDS Education and Prevention.

Twenty-four participants living with HIV between the ages of 15-24 were recruited for the study. They were recruited primarily through HIV clinics as well as through flyers posted at clinics and hospitals. Participants were either heterosexual males and females, cisgender men who have sex with men and transgender women. Participants were asked questions about medication, barriers to adherence, side effects, access to medications and care, relationships, mood and substance use and receiving information.

Researchers found that barriers to ART adherence included individual barriers such as lack of knowledge, complex medication schedules, depression; interpersonal barriers like potential stigma from friends and family; and structural barriers like access to transportation and medications. Transgender women reported feeling stigmatized at health care settings and many described that engagement in sex work is an issue that impacts adherence. Based on suggestions given by participants, the authors suggest that using technology, HIV+ peer groups and positive-framed messaging are steps future interventions can take to improve adherence.