Factors influencing improved adherence and retention among men living with human immunodeficiency virus in sub-Saharan Africa: A scoping review

Abstract

Background: In sub-Saharan Africa (SSA), men are more likely than women to experience numerous treatment interruptions after receiving a human immunodeficiency virus (HIV) diagnosis and starting treatment. As this can lead to poor adherence and retention in care, there is a need to address it to achieve epidemic control.
Aim: This scoping review aimed to synthesise current evidence on the factors influencing improved adherence and retention to care among men living with HIV in SSA.
Method: A comprehensive literature search was performed across multiple electronic databases to identify studies published from 2019 to 2024. The authors independently analysed the titles and abstracts before exporting the articles to Endnote. Of the 550 studies identified in the peer-reviewed literature, 474 remained after removing 76 duplicates, with only nine being included after reading the full article.
Results: The findings revealed three themes and six sub-themes related to improving adherence and retention: support for men (improve men’s HIV knowledge and peer support), digitalisation of antiretroviral therapy (ART) programme (appointment reminders) and improving access to ART services (community-centred services, differentiated model of care and flexible accessible services).
Conclusion: Improving adherence and retention in care for men living with HIV requires a multifaceted approach that addresses the unique social, structural, family challenges and psychological barriers they face. Strategies should include targeted health education, stigma reduction and the integration of gender-sensitive services that resonate with men’s health-seeking behaviours.
Contribution: This study summarised the strategies that can be put in place to improve adherence and retention in care among men living with HIV.