The challenges to antiretroviral adherence among MSM and LGBTI living with HIV in Nairobi, Kenya – A qualitative study
It is now possible for antiretroviral therapy (ART) to reduce viral load to the point where an infected person is no longer, or much less, infectious to others. As a result, ‘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. HEARD conducted exploratory research with a key population focus in the form of a small pilot study to augment the very limited existing research on challenges to ART adherence in men who have sex with men (MSM) and lesbian, gay, bisexual, transgender, and intersex (LGBTI) communities living with HIV in east and southern Africa (ESA). This report presents the pilot study’s indicative evidence that the types of challenges experienced by MSM and LGBTI do not differ significantly to those experienced by the general population. However, indications do suggest MSM and LGBTI experience these challenges more often, acutely, and with less opportunity to overcome them. Within the constraints of this pilot, results recommend addressing the challenges to ART adherence for MSM and LGBTI from a human rights approach of decriminalisation and reducing stigma and discrimination in society. This paper provides an imperative and direction for further research to take forward the provisional findings of this pilot study.
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