‘My Tablets are on Top of the Fridge’: The Roles of Relationship Desire and Medical Mistrust in ART Adherence for HIV-Positive MSM and Transgender Women Living in Rural South Africa

Joseph Daniels, Helen Struthers, Kabelo Maleke, Tim Lane, James McIntyre, Tom Coates

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Given the high HIV prevalence for men who have sex with men (MSM) and transgender women in South Africa, there is limited understanding of social determinants that influence antiretroviral treatment (ART) adherence. Although universal testing and treatment (UTT) is available, ART adherence remains suboptimal. We conducted focus groups with MSM and transgender women in order to understand factors influencing their ART adherence in Mpumalanga, South Africa. All focus groups were audio-recorded, transcribed and translated for analysis using a constant comparison approach, guided by the concept of Therapeutic Citizenship. We found there is medical mistrust of ART based on differing interpretations of HIV cure that may influence treatment adherence behaviors within social networks, and relationship desire had a significant influence on optimal ART adherence. Our findings suggest that clinics must provide interventions that integrate HIV disclosure and relationship skill-building to support optimal ART adherence for MSM and transgender women under UTT.

Original languageEnglish (US)
Pages (from-to)2849-2858
Number of pages10
JournalAIDS and Behavior
Volume23
Issue number10
DOIs
StatePublished - Oct 1 2019
Externally publishedYes

Keywords

  • ART
  • HIV
  • Medical mistrust
  • Relationships
  • South Africa
  • Treatment adherence

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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