EXPLORING HIV HEALTHCARE SERVICE ACCESS ISSUES EXPERIENCED BY ADOLESCENTS LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (HIV) IN AN HIV-DESIGNATED HEALTHCARE CENTER IN ESWATINI

Abstract

Background: HIV remains the leading cause of death among adolescents in Eswatini. The prevalence of HIV among adolescents is increasing as is the number of adolescents living with HIV who experience HIV service access issues. In Eswatini, previous studies explored general experiences of ALHIV with a limited focus on access to HIV healthcare services. The study aimed to describe access issues to HIV healthcare services among adolescents living with HIV in an HIV-designated healthcare center in Eswatini, while exploring the factors influencing HIV service access and suboptimal compliance to HIV treatment. Methodology: The study used an exploratory-descriptive qualitative design. Adolescents were sampled using purposive sampling and healthcare providers were sampled through convenience sampling. Results: Adolescents face challenges that limit their ability to perceive a need for HIV care, seek HIV care, reach HIV care, pay for HIV, and engage in HIV care. This is despite some efforts made by the health system through its five dimensions of healthcare access as outlined in the Levesque conceptual framework to facilitate their visibility and success in enhancing adolescents’ abilities. Discussion: Both the health system factors, and HIV service beneficiaries influence the accessibility of HIV services. A unified effort is needed to address the HIV service access issues experienced by adolescents living with HIV if the country is to achieve local and global HIV targets by 2030. Conclusion: Adolescents living with HIV are a uniquely vulnerable population facing challenges around accessing HIV services and engaging in sustained HIV care. Promoting access to HIV services for the most vulnerable adolescents will require interventions that address both social and health system factors. The findings have implications for programs that will empower both the health system and adolescents living with HIV.