Exploring the role of social support in viral suppression among adolescents and young adults living with HIV in Homabay County, Kenya

Abstract

IntroductionIn 2022, there were 1.3 million new HIV infections reported globally, with 50% of these occurring in sub-Saharan Africa. In Kenya, adolescents and young adults living with HIV (YLH) accounted for 38% of new HIV infections in 2020. Viral suppression among YLH lags other age groups, with 89.2% unsuppressed compared to 94.9% among adults nationally. Social support plays a key role in influencing viral suppression. In this study, we explored how different forms of social support influence viral suppression among YLH with and without viral suppression. Methods This was a qualitative study that utilized in-depth interviews and focus group discussions. Purposive sampling was used to recruit 30 YLH for individual interviews, 18 parents/caregivers, and 18 healthcare workers for focus group discussions (FGDs) at three health facilities, in Homabay Kenya. Card sorting activities were employed during interviews and FGDs to identify values and tradeoffs in social support decision-making. Thematic analysis was used to identify patterns of social support impacting viral suppression. Results The study revealed that YLH require consistent instrumental, informational, and emotional support to manage their HIV effectively, with significant challenges identified in maintaining treatment adherence due to inconsistent support and stigma, especially in school environments. Inadequate support negatively impacted medication adherence and viral load management, emphasizing the need for continuous caregiver and healthcare provider involvement. Recommendations include providing age-specific counseling by healthcare providers to deliver emotional and informational support tailored to the varying capacities and understanding of younger and older YLH. Integrating HIV care in schools and offering incentives can provide the practical assistance needed to strengthen treatment adherence. Continuous education for caregivers and YLH, along with the establishment of peer support groups, is necessary to reduce community stigma and build stronger social support networks. Comprehensive social support systems are essential to improve health outcomes and ensure effective HIV management for YLH. ConclusionMaintaining a robust social support system is essential for YLH, irrespective of their viral suppression status. Interventions among YLH should prioritize comprehensive support strategies, encompassing practical assistance, emotional encouragement, and guidance, to address their needs holistically across all treatment stages.