A qualitative dyad analysis of barriers and facilitators of antiretroviral therapy (ART) adherence among people who inject drugs (PWID) with HIV in Kazakhstan
Neuenschwander P. Altice F.L. Remien R.H. Mergenova G. Sarsembayeva L. Rozental E. Gulyayev V. Davis A.
2025Routledge
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
2025#37Issue 1151 - 160 pp.
People with HIV (PWH) who inject drugs (PWID) face many barriers to ART adherence. Kazakhstan has one of the fastest growing HIV epidemics in the world, primarily fueled by injection drug use, yet ART adherence among PWID is low. Social support can help address these barriers, but ART adherence among PWID is rarely examined within the relationship context. We conducted interviews with 20 PWID with HIV and 18 of their intimate partners and performed a qualitative dyad analysis to examine ART adherence factors. The results indicated many barriers and facilitators of ART adherence at the individual level (e.g., substance use), interpersonal level (e.g., social support) and structural level (e.g., stigma, transportation). Reported adherence barriers and facilitators had high congruence between dyad members; however, some notable differences were found between dyads. Compared to PWH, partners without HIV had a lack of awareness about the role of stigma in impeding ART adherence. Different manifestations of social support to facilitate ART adherence were noted between seroconcordant dyads (e.g., taking pills together, attending appointments together) and serodiscordant dyads (e.g., reminders to take pills, providing babysitting to enable attendance at doctor appointments). Future research and programs may benefit from integrating dyad approaches into ART adherence interventions.
ART adherence , dyad , HIV , People who inject drugs
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School of Public Health, State University of New York-Downstate Health Science University, Brooklyn, NY, United States
Section of Infectious Diseases, Department of Medicine, Yale University, New Haven, CT, United States
Division of Gender, Sexuality & Health, HIV Center, New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, United States
Global Health Research Center of Central Asia, Almaty, Kazakhstan
School of Social Work, Columbia University, New York, NY, United States
School of Public Health
Section of Infectious Diseases
Division of Gender
Global Health Research Center of Central Asia
School of Social Work
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