Psychosocial Support Interventions for Improved Adherence and Retention in ART care for Young People Living with HIV (10-24 years): A Scoping Review

Abstract

Background: Mental health disorders such as high levels of anxiety, isolation, depression and suicide ideation reported among young people living with HIV (10-24 years; YPLWH) contribute significantly to poor medication adherence and retention in care. While there is evidence supporting the role of psychosocial support interventions in promoting adherence and retention in antiretroviral treatment (ART) among adults living with HIV, there is little evidence on the role of psychosocial support on medication adherence among YPLWH. This scoping review was designed to identify and classify the types and effects of psychosocial support interventions designed to improve adherence and retention in ART among adolescents and young people living with HIV globally.Method: We searched six electronic databases (i.e., Scopus, Pubmed and EBSCOHost (Academic Search Premier, CINAHL, Psycarticles and Medline). Six relevant articles published between 2011 and 2019 met our inclusion criteria. We extracted information relevant to the nature and outcomes of the reported interventions using thematic content analysis informed by the Population, Intervention, comparison, outcome, and time (PICOT) framework.Results: Four distinctive treatment modalities that focused on improving ART adherence and retention in care were identified: individual counselling, support groups, family-centered services, and treatment supporters.Conclusion: There is a dearth of psychosocial support interventions to improve adherence and retention in ART amongst adolescents and young adults living with HIV. Future research and programming should seek to address psychosocial support interventions or approaches specifically designed to address the needs of adolescents and young adults living with HIV.PROSPERO: Registration CRD42018105057

Psychosocial support for HIV serodiscordant couples

“…During their period of severe distress after obtaining results, family members were often there to offer support. This is similar to findings from other studies; for instance, Okonji et al ( 2020 ) who believe that social support is an important factor for health maintenance. Kumala et al ( 2022 ) established that family social support has a positive influence on people living with HIV as they face stress related to health-disease process, contributing towards the treatment against HIV and dealing with aspects related to the fear of death.…”

“…Focused on education and counselling, psychosocial support can be associated with the following positive outcomes: increased rates of disclosure, greater treatment adherence, reduction in unprotected sex as well as HIV transmission (Mashaphu, Burns, Wyatt, & Vawda, 2018 ). In addition, utilisation of psychosocial interventions such as counselling, cognitive behavioural therapy, and peer support have proved to be effective in improving the mental health and overall well-being of people living with HIV (Okonji, Mukumbang, Orth, Vickerman-Delport, & Van Wyk, 2020 ). Such psychosocial support interventions are specifically meant to promote HIV disclosure and communication, address feelings of emotional-related distress, and challenges associated with HIV serodiscordancy (Schotanus-Dijkstra et al, 2017 ).…”

“…With this background, the provision of psychosocial support becomes critical (Mwakalapuka, Mwampagatwa, Bali, Mwashambwa, & Kibusi, 2017 ; Reed et al, 2021 ). Study findings by Okonji et al ( 2020 ), demonstrated that communities play a vital role in providing psychosocial support for people living with HIV. Mukumbang et al ( 2019 ) reported that family/household centred services were found to enhance family cohesion and communication, and such enhances shared responsibility of caring for people living with HIV.…”

Applying the biopsychosocial model to unpack a psychosocial support intervention designed to improve antiretroviral treatment outcomes for adolescents in South Africa

“…Psychosocial support (PSS) interventions can help ALHIV overcome barriers to adherence and retention in ART care thereby improving immunological health outcomes [ 24 ]. However, there are currently limited understanding on how psychosocial support interventions improve adolescents´ ART adherence, retention in care and immunological health outcomes [ 25 ]. A recent scoping review showed that individual and group counselling including family-centred group counselling and the use of adolescent treatment supporters were commonly used intervention to improve ART adherence, linkage to care and/or retention in care among adolescents living with HIV [ 25 ].…”

“…However, there are currently limited understanding on how psychosocial support interventions improve adolescents´ ART adherence, retention in care and immunological health outcomes [ 25 ]. A recent scoping review showed that individual and group counselling including family-centred group counselling and the use of adolescent treatment supporters were commonly used intervention to improve ART adherence, linkage to care and/or retention in care among adolescents living with HIV [ 25 ]. Using the biopsychosocial model [ 26 ], we formulated hypotheses to explain how the components of the RTC ALHIV intervention is designed to improve adherence to ART and retain ALHIV in ART to improve health outcomes.…”