Table 1 Characteristics of included studies
Study/location/settings | Participants | Study design | Data analysis methods | Aim | Subthemes | Findings |
|---|---|---|---|---|---|---|
[47] Fournier (2014) Uganda/community | 13 HIV-infected and orphaned youths (5 females) 12–18 years, living in a group home | Photovoice and FGD | Thematic analysis | To explore the experience of orphaned, HIV-seropositive children who live in a group home in Semi-urban Western Uganda. | Hopes and dreams Material resources Social support Stigma and discrimination Psychological, emotional and social challenges | Needs, social support, and challenges |
[48] Mutumba (2015) Uganda/clinical research center | 38 HIV-positive youths (20 females) 12–19 years | Interviews | Thematic analysis | To identify the psychosocial challenges and coping strategies among perinatal HIV-infected adolescents in Uganda | HIV stigma Disclosure Adherence Coping strategies | Challenges of living with HIV and coping strategies in youths |
[49] Bakeera-kitaka (2008) Uganda/health facility | 75 HIV-infected youths (35 females) 11–21 years | FGDs | Thematic analysis | To assess sexual and reproductive health needs and problems as well as determinants of sexual risk taking among young people living with HIV aged 11–21 years attending the pediatric infectious disease clinic in Kampala. | Information and misconceptions about sexual and reproductive health | Barriers to adopting protective behavior, behavioral skills adopted by youths for protective behavior, health care providers’ perception on sexual reproductive health-related needs of YLWHA |
Adolescents’ motivations for adopting protective behaviors | ||||||
Perceived barriers for adopting protective behaviors | ||||||
Behavioral skills adopted by adolescents for protective behaviors | ||||||
Health care providers’ perceptions on SRH-related needs of YPLH | ||||||
[50] Rana (2015) Uganda/health facility | a39 HIV-infected youths 14–24 years | FGDs | Thematic analysis | To explore perspectives of youth on the acceptability and feasibility of SMS-based interventions. | Feasibility of the Intervention | Perceived challenges of the intervention and suggestions for improvement. |
Programmatic Challenges and Suggestions | ||||||
Pathway Mechanisms | ||||||
[51] Kawuma (2014) Uganda/medical research centers | 26 HIV-positive youths (12 females) 11–13 years, 10 Caregivers, 5 Health workers. | Interviews | Thematic analysis | To examine the reasons for non-adherence to ART among children and why they may not report when they miss their treatment. | Not knowing the reasons why, one should take the drugs | Reasons for nonadherence, reasons for not disclosing nonadherence. |
Lack of food and side-effects | ||||||
Fear of being seen by others | ||||||
Lack of time | ||||||
To protect and maintain relations with carers and healthcare workers | ||||||
Fear of being scolded | ||||||
[52] Inzaule (2016) Uganda/health facility | 11 nurses, 9 adherence counselors, 5 medical doctors, 5 expert patients, 3 pharmacists. | Interviews and FGDs | Thematic analysis | To assess challenges to long-term adherence in adolescents and adults in three regional HIV-treatment centers in Uganda. | Unstructured treatment holidays | Challenges to adherence disaggregated for youths and adults |
Delays in disclosing HIV status to perinatally infected children | ||||||
Diminishing or lack of family support | ||||||
Perceived and experienced stigma in boarding schools | ||||||
Declining or lack of clinic support | ||||||
Temporary migrants and challenges with treatment access | ||||||
Disclosure in intimate relationships | ||||||
Treatment-related factors | ||||||
Staff shortages and missed counseling opportunities | ||||||
[53] Nabukeera-Barungi (2015) Uganda/health facilities | a336 HIV-infected youths 10–19 years, 46 Caregivers | bMixed methods: qualitative (interviews, key informant interviews and FGDs) and quantitative retrospective record review. | Thematic analysis | To describe the level and factors associated with adherence to antiretroviral therapy as well as the 1 year retention in care among adolescents in 10 representative disctricts in Uganda. | Barriers to adherence to ART | Level of adherence, factors associated with adherence and retention in care |
Facilitators of adherence and retention in care | ||||||
[54] Abubakar (2016) Kenya/medical research center | 12 HIV-infected youths (3 females) aged 12–17 years and 7 HIV-uninfected youths (5 females) 12–17 years, Caregivers of HIV-infected youths (n = 11), Community health workers (n = 8), Teachers and education administrators (n = 6) | Interviews | Thematic analysis | To investigate psychosocial challenges faced by HIV infected adolescents on the Kenyan coast. | Poverty as a salient challenge for families with HIV | Psychosocial challenges |
Poor mental and physical health | ||||||
Confronting a school system that is not responsive to their needs | ||||||
Partial disclosure to family and peers | ||||||
Stigma | ||||||
Medical adherence | ||||||
[55] Hagey (2015) Kenya/health facility | 40 health care providers | Interviews | Thematic analysis | To explore barriers and facilitators adolescent females living with HIV face in accessing contraceptive services. | Stigma of sexual promiscuity in accessing contraception without a partner | Barriers to access contraception and facilitators to contraception |
Concerns of negative parental attitudes towards adolescent sexual activity | ||||||
Discouragement from seeking contraceptive services due to being different from peers | ||||||
Provider interactions and bias of adolescent sexual activity influence contraceptive services offered | ||||||
Targeted youth-friendly services encourage adolescents to seek contraceptive services | ||||||
Ease of accessing contraception through integration of HIV and contraceptive services | ||||||
[56] Lypen (2015) Kenya/community | 53 HIV-infected youths (26 females) 18–27 years. | FGD | Thematic analysis | Tobetter understand the complex support system among HIV-positive youth and related coping mechanisms | Types of social support | Social support types, sources and their influence on management and coping with HIV |
Sources of social support | ||||||
[57] Gachanja (2015) Kenya/health facility | 7 HIV-infected youths (3 females) and 5 HIV- negative youths (3 females) 12–17 years. | Interviews | Thematic analysis | To explore post-disclosure experiences of children. | Acceptance of illness | Challenges following disclosure and coping mechanisms |
Stigma and discrimination | ||||||
Medication consumption | ||||||
Sexual awareness | ||||||
Coping mechanisms | ||||||
[58] Ramaiya (2016) Tanzania/health facility | 24 HIV-infected youths (18 females) 13–23 years. | Interviews | Thematic analysis | To identify salient psychosocial and mental health challenges of HIV-positive youth in a resource-poor Tanzanian setting | Living with HIV | Psychosocial challenges of living with HIV |
Domestic and Family Environments | ||||||
[59] Nyogea (2015) Tanzania/health facility and community | 116 HIV-infected youths (49 females) 2–19 years for the quantitative part, a35 HIV-infected youths 13–17 years for qualitative part, 21 Caretakers and 2 Health workers | bMixed methods: quantitative cross-sectional and qualitative FGDs and Interviews. | Thematic analysis | To estimate adherence levels and find the determinants, facilitators and barriers to ART adherence among children and teenagers in rural Tanzania. | Facilitators of treatment adherence | Adherence levels, determinants of adherence, barriers and facilitators of adherence. Disclosure of HIV status |
Treatment adherence barriers | ||||||
[60] Busza (2013) Tanzania/community | 14 HIV perinatally infected youths (5 females) 15–19 years, 10 Caregivers and 12 home-based care providers | Interviews | Thematic analysis | To explore how adolescents in Tanzania with HIV experience their nascent sexuality, as part of an evaluation of a home-based care program | Postponing sexuality | Perceptions of youths living with HIV about sexuality and HIV |
Sex, risk, and health | ||||||
Expectations for the future | ||||||
[61] Busza (2014) Tanzania/community | 14 HIV perinatally infected youths (5 females) 15–19 years, 10 Caregivers and 12 home-based care providers | FGDs and interviews | Thematic analysis | To examine the experiences of adolescents living with HIV in Tanzania in order to improve home-based care to better meet their needs | Adolescents’ participation in care | Perceptions of youths and HBC providers about home-based care |
Perceptions of current services | ||||||
HBC providers’ experiences | ||||||
[62] Mutwa (2013) Rwanda/health facility | 42 HIV-positive youths (19 females) 12–21 years, 10 Caregivers | Interviews, FGDs and role-playing | Thematic analysis | To understand adherence barriers for Rwandan adolescents | Desire to be Healthy | Challenges of living with HIV and social support |
Stigma and Desire for Privacy | ||||||
Disclosure of HIV Status | ||||||
Acceptance, Isolation and Depression | ||||||
Social Support and Living Situations | ||||||
Medication and Regimen Issues |