Published in PLOS One on 2026-03-02, 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: Odylia Muhenje, Charles O Olungah, Dalmas O Omia, Raphael O Ondondo, Paul Waswa, Adelaide Lusambili
Source: PLOS One • DOI 10.1371/journal.pone.0322823
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) poses significant health challenges. Despite ongoing efforts to scale up Antiretroviral therapy (ART) to save lives from AIDS-related morbidity and mortality,adherence among young adults remains low at 65% in sub-Saharan Africa.
Our study aimed to inform the development of youth-friendly, context-sensitive programs that are both scalable and sustainable in urban informal settlements. This paper presents findings on youth facilitators to ART adherence in Kibera informal settlement.
The study was conducted in Nairobi urban informal settlement of Kibra, Nairobi county, Kenya.
We utilized in-depth interviews (n = 25) and key informant interviews (n = 10) to collect data on faciliators to ART adherence among purposively selected eligible partcipants. Thematic analysis framework was employed to analyze the data.
HIV adherence facilitators encompassed patient-related factors like self-acceptance and open disclosure, health system factors such as accessibility, provider relationships, and patient reminders, and socio-economic aspects including support groups, education awareness, family support, and economic empowerment.
The findings emphasize the need for tailored, age-appropriate, and context-specific interventions in informal settlements to enhance HIV adherence. Fostering self-acceptance, creating an enabling environment through youth friendly services, improving provider-patient relationships, and leveraging social support systems such as peer groups and educational initiatives are essential strategies. Integrating these elements into programmatic and policy frameworks will ensure that interventions resonate with the unique realities of this populationpromoting sustainable adherence outcomes.
The findings will provide a foundation for developing context-sensitive interventions and programs to improve adherence in similar settings.
1. Introduction
According to several studies, HIV/AIDS remains a significant global public health challenge, with sub-Saharan Africa (SSA) bearing the highest disease burden [1,2]. Young adults, particularly those aged 15–24, are disproportionately affected [3]. According to UNAIDS 2024 HIV estimates, nearly 5 million youths were living with HIV in SSA, accounting for approximately 60% of the world’s HIV-positive youth population [4]. In 2023, Kenya’s HIV prevalence was 3.3%, higher among females (4.5%) than males (2.2%). Of 1.38 million people living with HIV, 85% were adults (25+), 10% youth (15–24), and 5% children (<15). New infections totaled 16,752, with 48% in adults, 31% in youth, and 21% in children [5]. This rate of infection among young adults highlights the vulnerabilities among this population of young adults [6]. The global HIV prevalence is 1.2% with the largest prevalence of 9.0% reported in sub-saharan Africa [7].
Despite ongoing efforts, antiretroviral therapy (ART) adherence among adolescents and young adults (AYAs) in sub-Saharan Africa remains alarmingly low at 65% [3,8]. This represents a significant drop from 84% [9]. Despite the fact that retention in care and consistent treatment are essential to achieving UNAIDS’ 2030 targets, young adults in Africa continue to struggle from social stigma and peer pressure to the intense psychological challenges of adolescence that makes it difficult for AYAs to maintain consistent treatment [10–12].
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 financing & policy 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 Odylia Muhenje, Charles O Olungah, Dalmas O Omia, Raphael O Ondondo, Paul Waswa, Adelaide Lusambili. 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: “The injection gives freedom” – An exploration of long-acting injectable HIV treatment acceptance among patients seeking care in two Nairobi tertiary hospitals
- Evidence brief: Acceptability of Suubi+Adherence intervention to improve ART adherence in Southern Uganda: A qualitative analysis
- Evidence brief: Translating research into action: Policy recommendations for strengthening antiretroviral therapy adherence in Ghana based on empirical evidence
