{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T08:20:46Z","timestamp":1794385246879,"version":"4.9.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>With the 2025\u202fUNAIDS 95-95-95 deadline upon us, significant gaps remain in achieving universal HIV care and treatment targets, particularly in Sub-Saharan Africa. Despite years of intensified global efforts, progress has lagged, partly driven by the multifaceted challenges of non-adherence to ART, shaped by social, economic, structural, and individual factors. These challenges have been compounded by the ever-changing landscape of global HIV funding, further undermining treatment outcomes. Addressing these interconnected barriers is essential to identify and implement targeted, evidence-based solutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To explore these challenges and potential interventions, a scoping review was conducted, searching through PubMed and Dimensions databases for peer-reviewed articles published from 2020 through February 2025. Eligible studies focused on barriers to ART adherence in adult men and women \u2265 18\u202fyears old living with HIV, aligning with the UNAIDS 95-95-95 framework in sub-Saharan Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 4,928 articles screened, 21 were included in this scoping review. Although the search period was extended to February 2025, no eligible studies published in 2025 were identified. Barriers to ART adherence were multifaceted, spanning individual-level issues such as mental health issues and substance abuse; social barriers including stigma and intimate partner violence; and economic factors, including food insecurity, transport costs, and income instability. Structural barriers such as health system fragmentation, clinic accessibility, and drug stockouts were also common and often worsened by the COVID-19 pandemic, which disrupted service delivery and exacerbated socioeconomic vulnerabilities. While only peer-reviewed articles were included in the analysis, recent UNAIDS reports and reputable media sources, such as The Guardian, were referenced to contextualize the emerging impact of the 2025 HIV funding cuts, which have not yet been reflected in the academic literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings emphasize the urgent need for targeted, multi-level interventions to address persistent economic, social, psychological, and policy barriers to ART adherence. A sustainable funding framework, combined with financial support, mental health services, and community-based care models, is crucial for improving retention and long-term adherence. These insights are essential for shaping policies, strengthening HIV service delivery, and sustaining momentum toward the 95-95-95 targets amid systematic challenges.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1609743","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T01:23:49Z","timestamp":1749518629000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":64,"title":["Barriers to ART adherence in sub-Saharan Africa: a scoping review toward achieving UNAIDS 95-95-95 targets"],"prefix":"10.3389","volume":"13","author":[{"given":"Judie","family":"Magura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sibongile R.","family":"Nhari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thokozani I.","family":"Nzimakwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"ref1","year":"2021"},{"key":"ref2","volume-title":"Progress towards the 90-90 targets ending AIDS GLOBAL AIDS UPDATE.","year":"2017"},{"key":"ref3","year":"2024"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1080\/09540121.2018.1524119","article-title":"Quality of care and HIV service utilization among key populations in Zambia: a qualitative comparative analysis among female sex workers, men who have sex with men and people who use drugs","volume":"31","author":"Pilgrim","year":"2019","journal-title":"AIDS Care"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e1002183","DOI":"10.1371\/JOURNAL.PMED.1002183","article-title":"Patient-reported barriers to adherence to antiretroviral therapy: a systematic review and Meta-analysis","volume":"13","author":"Shubber","year":"2016","journal-title":"PLoS Med"},{"key":"ref6","year":"2022"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s12981-022-00475-y","article-title":"Predicting viral load suppression by self-reported adherence, pharmacy refill counts and real time medication monitoring among people living with HIV in Tanzania","volume":"19","author":"Ngowi","year":"2022","journal-title":"AIDS Res Ther"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e17418","DOI":"10.2196\/17418","article-title":"Acceptability of a mobile phone support tool (call for life Uganda) for promoting adherence to antiretroviral therapy among young adults in a randomized controlled trial: exploratory qualitative study","volume":"9","author":"Twimukye","year":"2021","journal-title":"JMIR Mhealth Uhealth"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1111\/tmi.13473","article-title":"Association between HIV stigma and antiretroviral therapy adherence among adults living with HIV: baseline findings from the HPTN 071 (PopART) trial in Zambia and South Africa","volume":"25","author":"Jones","year":"2020","journal-title":"Trop Med Int Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1816","DOI":"10.1007\/s10461-019-02754-8","article-title":"Changes in ART adherence relate to changes in depression as well! 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