Effects of violence on adherence to antiretroviral therapy among adolescents living with HIV in Lilongwe, Malawi

This mixed-methods study among adolescents living with HIV in Lilongwe, Malawi, found high levels of violence exposure, with 76.8% experiencing emotional violence, 53.0% sexual violence, and 30.5% physical violence. Violence was a significant barrier to antiretroviral therapy adherence, with adolescents exposed to emotional or physical violence being substantially less likely to adhere to treatment, while those with no violence exposure were more than three times as likely to achieve optimal adherence. Qualitative findings revealed underreporting of violence and missed screening opportunities within healthcare settings, partly due to the discontinuation of violence assessments. The study highlights the importance of integrating routine violence screening and support services into adolescent HIV care to improve treatment adherence and health outcomes

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