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Working to Advance Health Equity in Africa

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03.12.2015

The challenges to antiretroviral adherence among MSM and LGBTI living with HIV in east and southern Africa

“What are the challenges to antiretroviral therapy (ART) adherence among Men who have Sex with Men (MSM) and Lesbian, Gay, Bisexual, Transsexual, and Intersex (LGBTI) living with HIV in east and southern Africa?” This embodies the question formed by MSM and LGBTI community activists who attended an amfAR-organised one and a half day meeting to develop an LGBTI research agenda in 2014. This question, asked by the communities it concerns, is particularly topical given that ‘treatment as prevention’ has become the cornerstone of UNAIDS’s post-2015 global strategy to end AIDS by 2030. As the expansion of treatment provision continues, and access improves, adherence becomes a determining factor in the impact of ART for both treatment and prevention.

In response, HEARD conducted a systematic literature review (August 2015) revealing a knowledge gap around the research question, and is subsequently undertaking exploratory research in the form of a pilot study. A HEARD researcher has already met with a wide range of key informants in Kenya, with perceptions suggesting that although the majority of challenges to ART adherence for HIV positive members of the MSM and LGBTI communities are also found among the general population, they may be more acute and more prevalent given overlapping vulnerabilities and double stigma experienced by MSM and LGBTI communities and explored in the report (October 2015). A HEARD researcher is currently on a country visit in Uganda to augment the findings of the country visit to Kenya. The pilot study will be used to inform any decision to undertake further, regional research on the issue.

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