Efforts to combat the HIV/Aids epidemic require a stronger focus on managing viral load as well as monitoring adherence to antiretroviral therapy (ART). Adolescents living with HIV (ALHIV) are cited as having higher tendencies of poor viral load suppression (VLS) than other age groups. The main cause of this is poor adherence to ART.

A qualitative study was conducted in a sample of 10 adolescents living with HIV who receive ART at a primary healthcare facility in Lusikisiki in the Eastern Cape. The objective was to explore the causes of unsuppressed viral loads among these adolescents. The sample included both those who were diagnosed in early childhood (vertical transmission) and those who were diagnosed at an adolescent stage.

The study found that key contributors to viral load non-suppression include limited viral load literacy, which hinders ART adherence and understanding its importance; social and economic challenges, such as poverty, stigma and inadequate support; and cultural and psychosocial barriers, including fear of disclosure and emotional distress relating to their HIV status.

These findings indicate the complexities relating to achieving the UNAIDS 95-95-95 targets by 2030, especially for adolescents. Addressing these barriers will require a holistic approach that combines education, community engagement, and tailored psychosocial support to empower adolescents and foster treatment adherence. By targeting these areas, healthcare providers and policymakers can enhance treatment outcomes and improve the overall wellbeing of ALHIV.