Date of Conferral

2022

Degree

Ph.D.

School

Public Health

Advisor

Michael Schwab

Abstract

Adolescents living with Human Immunodeficiency Virus (HIV) include those who were infected from their mother perinatally (PHIV) and those who were infected through sexual behaviors or drug use. Nigeria contributes the largest burden of children born with HIV globally, due to poor implementation of its prevention of mother-to-child transmission program. With advances in antiretroviral therapy (ART), more children and adolescents with HIV survive into adulthood. However, there are challenges to ART including access, uptake, adherence, and risks of long-term exposure. Using the social ecological model and a phenomenological approach, this qualitative study was designed to understand the experiences of adolescent Nigerian girls aged 15-19 years with PHIV, and their caregivers and health workers with respect to providing support. Interviews with three adolescent girls with PHIV, three caregivers, and three healthcare workers were conducted and analyzed. Findings indicated factors that hinder access to services and adherence to ART include low comprehensive HIV knowledge, HIV-related stigma, disclosure challenges, lack of transport fare to facility, and pills fatigue. Factors that strengthen access to services and adherence to ART include resilience of the girls, free and friendly family-centered healthcare services, the mother-child bond (both live with HIV), and support group meetings. Findings also show a decline in adverse drug reactions from antiretroviral drugs among these girls as the facility innovatively prevent and/or adequately manage these reactions. These findings highlight the implications for social change: improved quality of life for and optimal ways to support adolescent girls with PHIV in Nigeria.

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