Increased Screening for Adolescents at High Risk of Antiretroviral Non-Adherence

A short and simple evidence-based screening mechanism

A portrait of young girls smiling


Adolescents living with HIV are at higher risk of antiretroviral therapy (ART) non-adherence, and consequent mortality and morbidity, as compared to other age groups. There are many varied and interlinked aspects of adolescence that present complex adherence challenges for both adolescents and their treatment providers. These extend beyond taking tablets to the normative social, familial and psychological context inherent in this life stage.

Using the extensively implemented World Health Organization HEADSS assessment and the HIV specific HEADSS+ questionnaire, this research pinpoints the three components most associated with adolescents’ non-adherence to ART. A screening checklist focused on these three components within HEADSS and HEADSS+ can be used by practitioners more frequently to assess adolescents in need of extra support for ART adherence. It provides a practical tool offering feasibility and scalability for high-burden health workers and systems.

In identifying these key components, this brief also highlights key areas for interventions that can deliver more impactful provision of integrated services and support for adolescents living with HIV.  This brief is part of a broader series that aims to support the translation of research into improved adolescent SRH and HIV programming.

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