Published in PLOS One on 2026-04-24, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Josephine Nabayinda, Ozge Sensoy Bahar, Phionah Namatovu, Proscovia Nabunya, Samuel Kizito, Anita Kabarambi, April Thames, Fred M Ssewamala
Source: PLOS One • DOI 10.1371/journal.pone.0347112
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
In Uganda, 150,000 young people were living with HIV by the end of 2023. While Antiretroviral therapy (ART) is effective in reducing HIV transmission, youth in SSA, including in Uganda, face greater challenges with ART adherence compared to adults. Poverty-focused interventions have been recommended to improve adherence and viral load suppression. In this manuscript from Suubi+Adherence-Round 2 study, we explored the acceptability of Suubi+Adherence, a combination intervention aimed at improving ART adherence among adolescents living with HIV in Uganda that was tested in a six-year longitudinal study called Suubi+Adherence (2012–2018). We conducted semi-structured in-depth interviews with 36 youths who participated in the Suubi+Adherence intervention, which comprised matched savings accounts, mentorship, financial management, and business development training. Interviews explored participants’ motivations for joining, their experiences with the intervention, and the facilitators and barriers to intervention attendance. Informed by the Theoretical Framework of Acceptability, data were analyzed using thematic analysis and Dedoose software. Our results showed that the primary motivation for participation was the opportunity to learn about savings and income-generating activities. Participants also appreciated the Wisepill -an Electronic Monitoring Device, which reminded them to take their medication. Key facilitators for intervention attendance included transport reimbursements, family support, and content relevance. Challenges included long travel distances and associated costs, session timing conflicts with household responsibilities, and other personal obligations. Despite these challenges, participants highlighted the practical relevance of the intervention content, which aligned with their real-life experiences and needs. Our findings offer valuable insights into the acceptability of a combination intervention aimed at improving ART adherence among youth. These results have important implications for HIV treatment programs and policy in Uganda, particularly given the country’s high HIV prevalence. The parent randomized clinical trial is registered in the clinical trials database (NCT03307226).
Introduction
Sub-Saharan Africa (SSA) bears the highest HIV prevalence globally, with two-thirds of the 3.4 million youths aged 15–24 living with HIV worldwide residing in this region. [1]. Uganda, one of the hardest-hit countries in SSA, reports unprecedented numbers of young people living with HIV (YLHIV). As of 2023, 150,000 young people aged 15–24 were living with HIV in the country, with this age group accounting for 70% of all new HIV infections [2]. Effective Antiretroviral therapy (ART) has proven to be highly effective in reducing the risk of HIV transmission, as well as promoting virologic suppression, immune reconstitution, and decreased morbidity [3,4]. In addition to its clinical benefits, ART offers important social and economic advantages, such as improved quality of life [5,6], decreased stigmatization and discrimination associated with HIV [7], and increased productivity and workforce participation [8,9]. Conversely, poor adherence can lead to viral rebound, disease progression, and drug resistance, compromising clinical outcomes [10].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Josephine Nabayinda, Ozge Sensoy Bahar, Phionah Namatovu, Proscovia Nabunya, Samuel Kizito, Anita Kabarambi, April Thames, Fred M Ssewamala. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Participant perspectives on a person-centred care model for mobile individuals in HIV care from the SEARCH Dynamic Choice Treatment trial in rural Kenya and Uganda
- Evidence brief: The effect of antiretroviral therapy adherence on viral load suppression rate among people living with HIV in Ethiopia: A systematic review and meta-analysis
- Evidence brief: Evaluating the effects of community-based programs on viral rebound and viral suppression among HIV-positive orphaned and vulnerable children receiving antiretroviral treatment: Findings from the ACHIEVE project in Tanzania
