Barriers and facilitators of pediatric adherence to antiretroviral therapy: perspectives from caregivers in Türkiye

Turk J Pediatr. 2025 Sep 1;67(4):501-513. doi: 10.24953/turkjpediatr.2025.5730.

Abstract

Aim: This study aimed to describe barriers and facilitators of the adherence of children with human immunodeficiency virus (HIV) to antiretroviral therapy (ART) from the perspectives of their caregivers.

Methods: In-depth interviews were held with the caregivers of 15 children. The collected data were analyzed using thematic analysis procedures. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were followed in the study.

Results: The perspectives of caregivers were categorized under four themes and subthemes. Barriers and facilitators of the adherence of children with HIV to ART were categorized into 4 main themes: (1) medication-related, (2) child-related, (3) caregiver-related, and (4) health system-related. The results indicated that understanding the factors that influence pediatric ART adherence is critical to the development of adequate strategies. In addition, disclosure of HIV status to the child is also an important factor affecting drug administration in the social environment.

Conclusions: To ensure adherence to lifelong ART, targeted caregiver support through continuous supervision, clear guidance on drug preparation, and strategies for effective administration should be integrated into context-specific interventions that address the combined influence of factors related to the child, medication, healthcare, and of the sociocultural environment.

Keywords: adherence; antiretroviral therapy; barriers; children; facilitators; human immunodeficiency virus (HIV).

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents* / therapeutic use
  • Anti-Retroviral Agents* / therapeutic use
  • Caregivers* / psychology
  • Child
  • Child, Preschool
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / psychology
  • Humans
  • Interviews as Topic
  • Male
  • Medication Adherence* / psychology
  • Qualitative Research
  • Turkey

Substances

  • Anti-Retroviral Agents
  • Anti-HIV Agents