ArticlePLOS global public health2026
Barriers and facilitators to viral load suppression among adolescents and young people living with HIV receiving intensive adherence counselling in east central Uganda: A COM-B model-informed qualitative study.
Article in PLOS global public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
Suboptimal viral load (VL) suppression among adolescents and young people living with HIV (AYPLHIV) remains a major challenge to HIV control in Uganda. Although Intensive Adherence Counselling (IAC) is implemented as a structured intervention for individuals with unsuppressed viral loads, suppression rates among AYPLHIV remain low. Evidence on the contextual factors shaping VL suppression after IAC remains limited. This study explored barriers and facilitators to optimal adherence and engagement in IAC as a pathway to VL suppression among previously non-suppressed AYPLHIV aged 10-24 years who had undergone IAC in East-Central Uganda. A descriptive exploratory qualitative study design was conducted among participants purposively sampled across four districts. Data collection and analysis of individual-level factors were guided by the Capability, Opportunity, Motivation - Behaviour framework, while health system factors emerged inductively and complemented the COM-B framework. In total, 8 AYPLHIV, 4 caregivers, and 10 health workers participated. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed using thematic analysis. Most participants (64%) were female, and the median age of AYPLHIV was 16.5 years (interquartile range [IQR]: 14.5-20.5). Multiple individual-level factors influenced VL suppression. Capability barriers included forgetfulness, while facilitators included reminder routines. Opportunity barriers comprised economic hardship, parental resentment and social class-based reluctance, and non-disclosure of HIV status, whereas caregiver support was a facilitator. Motivation barriers included emotional distress and substance abuse, while facilitators included future aspirations and religious beliefs. Health system barriers included a rigid IAC delivery schedule, and long waiting time, whereas peer support and WhatsApp groups acted as facilitators. The findings highlight the need to redesign IAC from a predominantly facility-based intervention to an adolescent-responsive model that integrates peer-led engagement and flexible community-based service delivery to optimize viral suppression among high-risk AYPLHIV. Key words: viral load, intensive adherence counselling, suppression.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.