Adherence Support Strategies for Adolescents Living with HIV: A Nursing Perspective at Parirenyatwa Group of Hospitals Family Care Center, Harare, 2025

Abstract

This study investigates nurse-led adherence support strategies for adolescents living with HIV at Parirenyatwa Group of Hospitals Family Care Centre in Harare, Zimbabwe, in response to the persistent challenge of suboptimal adherence to antiretroviral therapy (ART) among this vulnerable population. Adolescents aged 15–24 face unique developmental and psychosocial barriers, including stigma, forgetfulness, mental health challenges, and social pressures, which negatively affect consistent medication intake and treatment outcomes. While global and regional evidence supports the effectiveness of nurse-led interventions such as adherence education, counselling, follow-up, and caregiver involvement, there is limited contextualized understanding of how these strategies are implemented and experienced within local clinical settings in Zimbabwe. The study adopted a mixed-methods research design to provide a comprehensive analysis of adherence support practices and outcomes. A sample of 60 adolescents was selected from the clinic’s patient registry using simple random sampling, while 15 nurses were purposively selected based on their experience in HIV care. Quantitative data were collected through structured questionnaires to assess adherence levels, while qualitative data were gathered through semi-structured interviews to explore nurses’ perspectives on adherence strategies and the challenges encountered. Data analysis involved descriptive statistics and inferential analysis to examine associations between adherence levels and influencing factors, alongside thematic analysis for qualitative data to identify emerging patterns and insights. The findings indicate that nurse-led strategies such as individualized counselling, peer support, treatment education, and routine follow-up significantly contribute to improved adherence among adolescents. However, several barriers persist, including stigma, inadequate family support, psychosocial stressors, and medication related challenges. The study concludes that although nurse-led interventions are essential in promoting ART adherence, there is a need for more holistic, adolescent-centered approaches that integrate psychosocial support and strengthen family and community involvement. Despite limitations such as reliance on self-reported adherence measures and the focus on a single clinical setting, the study provides valuable insights into adherence support within the Zimbabwean context. The findings offer evidence-based recommendations to enhance nursing practice, inform policy development, and improve health outcomes for adolescents living with HIV.