Original Research

Determinants of antiretroviral therapy adherence among transgender women in South Africa

Leonashia Leigh-Ann van der Merwe, Idah Moyo, Azwihangwisi H. Mavhandu-Mudzusi
South African Family Practice | Vol 66, No 1 : Part 2| a5869 | DOI: https://doi.org/10.4102/safp.v66i1.5869 | © 2024 Leonashia Leigh-Ann van der Merwe, Idah Moyo, Azwihangwisi H. Mavhandu-Mudzusi | This work is licensed under CC Attribution 4.0
Submitted: 13 November 2023 | Published: 29 April 2024

About the author(s)

Leonashia Leigh-Ann van der Merwe, Department of Health Studies, College of Human Sciences, University of South Africa, Pretoria, South Africa
Idah Moyo, Department of Health Studies, College of Human Sciences, University of South Africa, Pretoria, South Africa; and Department of HIV Services, Population Solutions for Health, Harare, Zimbabwe
Azwihangwisi H. Mavhandu-Mudzusi, School of Social Sciences, College of Human Sciences, University of South Africa, Pretoria, South Africa

Abstract

Background: Transgender women bear a huge burden of human immunodeficiency virus (HIV) in South Africa. However, they are not fully engaged in healthcare across the HIV continuum of care. In addition, transgender women face multiple facets of stigma and discrimination as well as socio-economic inequalities, which all have a negative impact on antiretroviral therapy (ART) adherence.

Objective: The study aimed at exploring and describing the experiences of ART adherence of transgender women living with HIV in the Buffalo City Metro Municipality.

Methods: The study employed an interpretative phenomenological analysis (IPA) design. Twelve participants were enrolled using a snowballing sampling technique. Data were collected using semi-structured interviews and analysed using an IPA framework.

Results: While exploring determinants to ART adherence among transgender women living with HIV in Buffalo City Metro, two superordinate themes emerged: enablers to ART adherence and psychosocial factors promoting adherence. The study found that factors such as differentiated ART service delivery, ARV medicines-related factors, motivators for taking treatment and support systems facilitated ART adherence.

Conclusion: Emerging from this study is the need to scale up differentiated, person-centred ART service deliveries that will enhance access and adherence to treatment for transgender women.

Contribution: This study provides unique insights on factors enhancing ART adherence among transgender women. There is a paucity of literature on access to HIV care services for key and vulnerable populations, and these findings will be shared in the country and in the region.


Keywords

ART adherence; determinants; HIV; continuity in treatment; transgender women

Sustainable Development Goal

Goal 3: Good health and well-being

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