Defining areas in which LGBTIQQ living with HIV need your support

Identifying and confronting hardships to ART adherence in Africa

MARPs in Uganda a local NGO, embarked on synthesizing reports from all its activities and uses standard knowledge development methods. Under the program “structural barriers to ART adherence in the Global South,” one of the themes is political-social ecology of HIV prevention initiatives. HIV prevention is impacted by a political-social ecology which sets the contexts in which achieving optimal ARV adherence may or may not be possible. Conservatism and neoliberalism has had an impact on privatization which in turn has an impact on ARV supply. Therefore, the business of managing an HIV+ve diagnosis relies on many players other than health personnel. The competing priorities may allow for exclusionary tendencies, cause capital accumulation, cater to human and structural priorities other than addressing inequality or meeting health goals. Literature review was done through Pub-Med, Medline, Political and Social research data bases, Google and Internet search to retrieve and download published materials used to generate articles in this review.This review examines how understanding political-social ecology explains the coercive, exclusionary, inclusions, participatory contexts and the inequality that follow in the wake of an otherwise well-intended HIV prevention initiative. Political will, import substitution industrialization, generic drug manufacture, regular attendances at clinics, frequency of refills, cost-benefit analysis (choices) ensuring long term care, consumer rights, and quality of service provision constitute enablers if optimal ARV adherence is to be achieved. This review highlights the harshness of poverty and how it forces many to forego ARVs and instead opt for alternatives whose consequences lead to non optimal ARV adherence. Marxist sociological frameworks are used in suggesting optimal ARV adherence. Areas for further research are also highlighted.