“Trajectories to HIV viral suppression and non-suppression: Case studies from rural East African adolescents and young adults in the SEARCH-Youth trial.”

Johnson-Peretz J, Onyango A, Akatukwasa C, et al. (2025). JIAPAC.

"I feared taking ARVs at first but, at the same time, had no option. It was hard taking them during the first days, but I got used to it in the long run. Time was another issue here; I first started taking them before 9 pm, but this was marked by lots of forgetfulness, and I had to change to 10 pm, after which things went well." (Female Participant 1, Baseline: VL: 40)

"After testing with the health providers that used to pass around the village, two female providers sat me down encouraging me to start taking the HIV medicine, though I was reluctant at the start. I even kept quiet and refused, but after delivering, the nurses told me that I would infect my child if I didn’t take the medicine. Then they explained to me what to do, gave me the medicine, and I went home with it." (Female Participant 2, Year 2: VL: 1 million)

Synopsis: We used a case-study approach based on semi-structured interviews conducted at three time points over two years to identify changes in the lives of 11 adolescents and young adults (aged 15-24 years) participating in an HIV intervention trial in rural communities in Kenya and Uganda. 
Key finding: Supportive family environments, high-quality service provision, and residential and partnership stability free of violence, or permitting freedom to move and maintain extensive social ties both inside and outside one’s immediate community, enabled antiretroviral therapy (ART) adherence.
Recommendations: To improve virologic suppression, clinical care and interventions should include assessments of and strategies for addressing food insecurity, ART disclosure, and home-based violence from intimate partners or other family members.