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Participants used photography to represent their perspectives and experiences.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>14 individuals participated in the research process. We developed a framework and identified four social domains which combined with the adolescent\u2019s own experiences and sense of self to either support or undermine adherence. Periods of non-adherence were reported by all participants. Participants described the importance of supportive relationships and households as well as the benefits of ART as supporting adherence. The fear of inadvertent disclosure of their HIV status and the side-effects of ART were barriers to adherence. Possible interventions to support adolescents in their treatment journey are identified.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Current models of adherence support fail to address the challenges to lifelong therapy ALHIV face. Ongoing education and honest communication with health care providers, interventions that build resilience together with peer support, have the potential to improve adherence in ALHIV.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-022-07780-x","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T12:05:59Z","timestamp":1666353959000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["\u2018If I am playing football, I forget that I have this virus\u2019: the challenges and coping strategies of adolescents with perinatally acquired HIV in KwaZulu-Natal, South Africa"],"prefix":"10.1186","volume":"22","author":[{"given":"Marian","family":"Loveday","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Furin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sindisiwe","family":"Hlangu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thabile","family":"Mthethwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasneem","family":"Naidoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,21]]},"reference":[{"key":"7780_CR1","unstructured":"World Health Organization. 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The consent included participation in the initial training workshop and FGD with audio recording of the FGD and permission to share the images presented, the voluntary terms of involvement in the study and the assurance of confidentiality and anonymity.\u00a0Patient anonymity was maintained by identifying each patient using a unique identification number. Ethical approval was obtained from the South African Medical Research Council (SAMRC) Ethics Review Committee (ED050-11\/2020) and the KwaZulu-Natal Health Research Committee. This research was carried out and approval and informed consent were obtained in accordance with the World Medical Assembly (WMA) Declaration of Helsinki\u2014Ethical Principles for Medical Research Involving Human Subjects.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent was obtained from all participants and where necessary a legal guardian for publication of identifying images in an online open-access publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no competing interests to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"796"}}