Perception of services and barrier to retention in care for girls and young women in Beira, Mozambique. Doctors with Africa CUAMM INGO

In 2020, Mozambique was the second country in the Sub-Saharan region for new HIV infections: 39.7% occurred among adolescents and young people (15-24 years), disproportionately higher among women (26.4% vs 13.3%). This study aimed to explore the perception of HIV services and the barriers to adherence to the antiretroviral treatment(ART), comparing adolescent girls and young women(AGYW) and pregnant and lactating AGYW(PL-AGYW) with HIV in Beira, Mozambique. Methods In June-July 2022 6 focus groups(FG) were conducted, 4 with AGWY with HIV(FG1) and 2 with PL-AGYW with HIV(FG2). The inclusion criteria were being older than 14 years old, being diagnosed with HIV at least by 6 months, and being in care in one of the youth health services supported by Doctors with Africa CUAMM, in Beira. The dimensions explored were access and perception of the service and barriers to adherence to the treatment. Results A total of 33 AYGW participated (median age:20 years), of which 12 PL-AGYW. Most of them were still students (19,57.6%), mainly in FG1(15,71.4%). For PL-AYGW, the main difficulty for the adherence was the ART side effects (6,50%), stigma (5,41.6%), and lack of knowledge (3,25%), while in the FG1 the main barriers were psychological factors (7,33.3%), such as depression, low self-esteem, and sense of hopelessness, lack of food (6,28.6%), lack of family support, problem to take the treatment at the same time of the day, and being negligent (5,23.8%). In both groups, the quality of attendance was the factor most appreciated, while the principal problems were lack of privacy (13,61.9%) and the space of the consultant room (7,33.3%). Conclusion AYGW represents a target group for HIV prevention and treatment. The barriers to ART adherence identified among PL-AYGW were different from the other girls, confirming that targeted interventions are needed to address this population. Stigma remained an issue: hence, guaranteeing privacy is crucial in HIV services.