Lost to follow up: the (non)psychosocial barriers to HIV/AIDS care in southeast Nigeria.

Publication date: Sep 04, 2023

Medication withdrawal remains a problem in Nigeria’s HIV care. The Enugu state of southeast Nigeria has 3,736 people living with HIV/AIDS (PLHIV), with a 1. 9% HIV-positive prevalence rate among the age band of 15-49 years, higher than 1. 3%, the national average for the same cohort. Despite the disease burden, many cases are “lost to follow-up” in this region. Through four focus groups of patients (20 participants in total) and in-depth interviews with four clinicians from four public hospitals, this study aimed to understand the barriers to attending healthcare appointments faced by young adults. The participants were recruited through flyers, posters, and snowballs at clinics; both data sets were first analysed separately yet used to triangulate each other. We found that clinical interruptions are mainly attributable to factors such as stigma, suicidal ideation, loss of means of livelihood due to PLHIV’s “new identities”, and thus poverty and malnutrition. These barriers, complicated by the COVID-19 pandemic and armed conflicts in the region, have made medication adherence further challenging. Therefore, we recommend the Nigerian government integrate non-biomedical support for PLHIV into people-centred HIV care.

Concepts Keywords
Hiv Antiretroviral therapy
Hospitals medication adherence
Interviews Nigeria
Nigeria psychosocial health
Snowballs stigma


Type Source Name
disease MESH Lost to follow up
disease MESH AIDS
drug DRUGBANK Albendazole
disease MESH suicidal ideation
disease MESH malnutrition
disease MESH COVID-19 pandemic

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