How does an unhappy home life affect HIV adherence in adolescents?
Adolescents living with HIV (aged 10-19) are known to have a lower level of commitment to their HIV treatment regimen when compared to other age groups, often needing special care. But what factors can impact this?
Family problems can have a huge impact on the success of HIV care in adolescents. The loss of parents or other family members, financial hardship, HIV stigma from within the family - all of this can lead to adolescents abandoning their HIV treatment.
A study in Kenya, following 104 people, has published their results in the Journal of the International AIDS Society (JIAS).
When analysing interviews and medical records the team identified a number of family-related factions that impact a young person’s adherence to HIV treatment:
- Adolescents living with HIV, who lost their parents, did not have access to HIV services due to new guardians or living situations (lack of house, lack of transportation to clinic or pharmacy). These issues were exacerbated by stigma which meant the adolescents felt unable to reveal their HIV status to their new family or guardians.
- The negative attitude of relatives to HIV - creating a culture of stigma within the family.
- Experience of abuse, both physical and psychological, that undermines the HIV care and treatment.
- Financial hardship, meaning there is no way to transport the young person to clinic, purchase medication or supporting nutrition.
- Lack of HIV knowledge and skills amongst parents and guardians, leading to a lack of support at home.
According to the study’s authors, the family environment has an important impact on an adolescent’s commitment to their HIV care and treatment. State and local assistance programs should be developed with a focus on improving family relations, reducing in-family stigma, developing care skills and resources, and empowering economic opportunities for adolescents living with HIV and their families.