Title:
From Awareness to Access: Community, Family-centred and Health System Approaches to Strengthening Antiretroviral Adherence in the Northwest Province, South Africa

Authors:
Masevhege Mambo Trevor, South Africa

Abstract:

Human immunodeficiency virus (HIV) remains one of the most serious Public Health threats of the 21st century. An estimated 40.8 million People are living with HIV (PLHIV) globally, and the number continues to rise despite progress in prevention, testing, and treatment, particularly the expansion of Antiretroviral (ARV) treatment. These figures highlight the urgent need to strengthen efforts to mitigate increasing infection and death rates. This study explored community-, family-centred, and health system approaches to enhance ARV treatment adherence among PLHIV in the Northwest Province, South Africa. A qualitative phenomenological design was employed with 12 purposively selected PLHIV aged 18–40 years who had defaulted from ARV treatment for 30–90 days and were traced back to the clinic. Data was collected using semi-structured, individual in-depth interviews guided by an interview guide, and analysed using Tesch's framework, which generated key themes from participants' narratives. Trustworthiness measures were applied, and the study adhered to ethical considerations throughout the research process. Findings reveal that adherence to ARV treatment is influenced by personal and systemic factors. Stigma, lack of community awareness, and emotional isolation hinder consistent treatment, while distant clinics, transportation challenges, medication shortages, and overworked health workers add complexity to care. Potential solutions include improved family and peer support, greater community education, home-based ARV distribution, and enhanced counselling. A comprehensive strategy addressing these interconnected issues can create a more supportive environment, ensuring treatment is accessible, comprehensible, and socially endorsed.

DOI: http://dx.doi.org/10.51505/ijmshr.2025.9601