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"Your status cannot hinder you": the importance of resilience among adolescents engaged in HIV care in Kenya.
- Source :
- BMC Public Health; 6/30/2022, Vol. 22 Issue 1, p1-13, 13p, 1 Diagram, 2 Charts
- Publication Year :
- 2022
-
Abstract
- <bold>Background: </bold>Approximately 40% of the 110,000 adolescents living with HIV (ALHIV) in Kenya have not achieved viral suppression. Despite the increasing availability of adolescent-friendly services, adolescents face barriers that impact ART adherence. This study aimed to identify key stigma-related barriers to ART adherence and strategies used by adolescents in overcoming these barriers.<bold>Methods: </bold>Data were collected by LVCT Health, a Kenyan organization with a programmatic focus on HIV testing, prevention, and care. 122 participants were recruited from 3 clinical sites affiliated with LVCT Health in Nairobi, Kisumu, and Mombasa. In-depth interviews were conducted with ALHIV (n = 12). Focus group discussions were conducted with ALHIV (n = 5), peer leaders (n = 3), and adolescents receiving HIV services in community settings (AIC) irrespective of HIV status (n = 3). Interviews and focus groups were audio recorded, translated, and transcribed. Data were analyzed thematically, with a focus on stigma and resilience.<bold>Results: </bold>While AIC primarily focused on adherence barriers and stigma, ALHIV and, to some extent, peer leaders, also identified resilience factors that helped overcome stigma. Four major themes emerged: 1) knowledge and future-oriented goals can drive motivation for ALHIV to remain healthy; 2) disclosure to others strengthens support systems for ALHIV; 3) medication-taking strategies and strategic disclosure can overcome adherence challenges in school; and 4) a supportive clinic environment promotes continuous adolescent engagement in HIV care. These concepts were used to develop a conceptual stigma/resilience model depicting how resilience moderates negative effects of stigma among ALHIV.<bold>Conclusions: </bold>This study demonstrates the positive effects of ALHIV resilience on ART adherence and illuminates how stigma impacts ALHIV differently depending on their resilience. Strengths-based interventions, focused on increasing resilience among ALHIV in Kenya, and more formal involvement of adolescent peers to bolster adolescent support, have the potential to improve ART adherence among ALHIV. [ABSTRACT FROM AUTHOR]
- Subjects :
- HIV-positive teenagers
ADOLESCENT health
PSYCHOLOGICAL resilience
FOCUS groups
Subjects
Details
- Language :
- English
- ISSN :
- 14712458
- Volume :
- 22
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Public Health
- Publication Type :
- Academic Journal
- Accession number :
- 157737122
- Full Text :
- https://doi.org/10.1186/s12889-022-13677-w