Lesotho has the second-highest HIV burden globally with persisting disparities in HIV infections among different population groups. Adolescents and young adults living with HIV (AYLHIV) face unique challenges, particularly when parental migration disrupts the social support structures crucial for adherence to antiretroviral therapy. The study explored the effects of parental migration on the treatment outcomes of AYLHIV in the Quthing district of Lesotho using social cognitive theory. SCT emphasises the role of individual and environmental factors in shaping behaviour. Data was collected through interviews with adolescents between the ages of 18 and 24, supplemented by healthcare providers’ insights.

The findings revealed that parental migration significantly disrupts the treatment adherence and emotional wellbeing of AYLHIV. While parental guidance and support from extended family members can mitigate adverse effects, these are not always sufficient. The role of NGOs in providing counselling, financial aid and educational assistance, is critical.

The key recommendations all relate to strengthening HIV care and support systems among AYLHIV. Healthcare workers should optimise care through patient-centred care plans, improve adolescent-friendly health services and enhance community health services. The community should foster supportive networks to reduce stigma through awareness campaigns and support youth-led initiatives. The Ministry of Health must ensure policy implementation, increase resource allocation for adolescent-friendly services and strengthen partnerships with stakeholders such as NGOs.