{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:10:40Z","timestamp":1785409840753,"version":"3.56.0"},"reference-count":40,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0In sub-Saharan Africa (SSA), men are more likely than women to experience numerous treatment interruptions after receiving a human immunodeficiency virus (HIV) diagnosis and starting treatment. As this can lead to poor adherence and retention in care, there is a need to address it to achieve epidemic control.\nAim:\u00a0This scoping review aimed to synthesise current evidence on the factors influencing improved adherence and retention to care among men living with HIV in SSA.\nMethod:\u00a0A comprehensive literature search was performed across multiple electronic databases to identify studies published from 2019 to 2024. The authors independently analysed the titles and abstracts before exporting the articles to Endnote. Of the 550 studies identified in the peer-reviewed literature, 474 remained after removing 76 duplicates, with only nine being included after reading the full article.\nResults:\u00a0The findings revealed three themes and six sub-themes related to improving adherence and retention: support for men (improve men\u2019s HIV knowledge and peer support), digitalisation of antiretroviral therapy (ART) programme (appointment reminders) and improving access to ART services (community-centred services, differentiated model of care and flexible accessible services).\nConclusion:\u00a0Improving adherence and retention in care for men living with HIV requires a multifaceted approach that addresses the unique social, structural, family challenges and psychological barriers they face. Strategies should include targeted health education, stigma reduction and the integration of gender-sensitive services that resonate with men\u2019s health-seeking behaviours.\nContribution:\u00a0This study summarised the strategies that can be put in place to improve adherence and retention in care among men living with HIV.<\/jats:p>","DOI":"10.4102\/phcfm.v18i1.5309","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T10:33:04Z","timestamp":1784629984000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors influencing improved adherence and retention among men living with human immunodeficiency virus in sub-Saharan Africa: A scoping review"],"prefix":"10.4102","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0109-5027","authenticated-orcid":false,"given":"Lebogang G.","family":"Matonyane","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8921-8318","authenticated-orcid":false,"given":"Andrew","family":"Ross","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Hlongwa M, Basera W, Hlongwana K, et al. Linkage to HIV care and early retention in HIV care among men in the \u2018universal test-and-treat\u2019 era in a high HIV-burdened district, KwaZulu-Natal, South Africa. BMC Health Serv Res. 2024;24(1):384. https:\/\/doi.org\/10.1186\/s12913-024-10736-3","DOI":"10.1186\/s12913-024-10736-3"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Matonyane LG, Ross A, Qolesa S, Sibeko Z. Interventions for reaching men to improve HIV testing services in sub-Saharan Africa: A narrative review. Afr J Prim Health Care Fam Med. 2025;17(1):a4869. https:\/\/doi.org\/10.4102\/phcfm.v17i1.4869","DOI":"10.4102\/phcfm.v17i1.4869"},{"key":"ref2","unstructured":"Prepwatch. Men and HIV: Understanding the challenges and advancing solutions to close the gap in the HIV response. New York, USA: PrepWatch (AVAC); 2023."},{"key":"ref3","unstructured":"UNAIDS. Engaging men and boys in HIV prevention and treatment: Guidance for East and Southern Africa [homepage on the Internet]. Joint United Nations Programme on HIV\/AIDS (UNAIDS); 2022 [cited 2026 Apr 14] Available from: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/east-south-africa-engaging-men_en.pdf"},{"key":"ref4","unstructured":"USAID. Interventions to Improve Adherence to Antiretroviral Therapy: A Review of the Evidence. Washington, DC, USA: United States Agency for International Development (USAID); 2006."},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Kusemererwa S, Akena D, Nakanjako D, et al. Strategies for retention of heterosexual men in HIV care in sub-Saharan Africa: A systematic review. PLoS One. 2021;16(2):e0246471. https:\/\/doi.org\/10.1371\/journal.pone.0246471","DOI":"10.1371\/journal.pone.0246471"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Mandawa MB, Mahiti GR. Factors contributing to loss to follow-up from HIV care among men living with HIV\/AIDS in Kibaha District, Tanzania. HIV\/AIDS. 2022;14:503\u2013516. https:\/\/doi.org\/10.2147\/HIV.S381204","DOI":"10.2147\/HIV.S381204"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Janek SE, Hatoum S, Ledbetter L, Relf MV. Understanding the stigma experience of men living with HIV in sub-Saharan Africa: A qualitative meta-synthesis. AIDS Behav. 2024;28(8):2500\u20132533. https:\/\/doi.org\/10.1007\/s10461-024-04329-8","DOI":"10.1007\/s10461-024-04329-8"},{"key":"ref8","unstructured":"Corwin MA, Bradley-Springer L. Getting HIV test results. Atlanta, Georgia, USA: Georgia Department of Public Health; 2013."},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Assefa Y, Lynen L, Wouters E, Rasschaert F, Peeters K, Van Damme W. How to improve patient retention in an antiretroviral treatment program in Ethiopia: A mixed-methods study. BMC Health Serv Res. 2014;14:45. https:\/\/doi.org\/10.1186\/1472-6963-14-45","DOI":"10.1186\/1472-6963-14-45"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Azia IN, Mukumbang FC, Van Wyk B. Barriers to adherence to antiretroviral treatment in a regional hospital in Vredenburg, Western Cape, South Africa. S Afr J HIV Med. 2016;17(1):476. https:\/\/doi.org\/10.4102\/sajhivmed.v17i1.476","DOI":"10.4102\/sajhivmed.v17i1.476"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Simelane PT, Simelane MS, Amoateng AY. Barriers and facilitators to adherence for antiretroviral therapy: The perspectives of patients from a wellness center in the Mpumalanga Province, South Africa. Afr Health Sci. 2022;22(3):455\u2013462. https:\/\/doi.org\/10.4314\/ahs.v22i3.49","DOI":"10.4314\/ahs.v22i3.49"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Ukoaka BM, Ugwuanyi EA, Ukueku KO, et al. Digital tools for improving antiretroviral adherence among people living with HIV in Africa. J Med Surg Public Health. 2024;2:100077. https:\/\/doi.org\/10.1016\/j.glmedi.2024.100077","DOI":"10.1016\/j.glmedi.2024.100077"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Joglekar N, Paranjape R, Jain R, et al. Barriers to ART adherence and follow ups among patients attending ART centres in Maharashtra, India. Indian J Med Res. 2011;134(6):954\u2013959. https:\/\/doi.org\/10.4103\/0971-5916.92642","DOI":"10.4103\/0971-5916.92642"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Dovel KL, Hariprasad S, Hubbard J, et al. Strategies to improve antiretroviral therapy (ART) initiation and early engagement among men in sub-Saharan Africa: A scoping review of interventions in the era of universal treatment. Trop Med Int Health. 2023;28(6):454\u2013465. https:\/\/doi.org\/10.1111\/tmi.13880","DOI":"10.1111\/tmi.13880"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Mukumbang FC. Leaving no man behind: How differentiated service delivery models increase men\u2019s engagement in HIV care. Int J Health Policy Manag. 2021;10(3):129\u2013140. https:\/\/doi.org\/10.34172\/ijhpm.2020.32","DOI":"10.34172\/ijhpm.2020.32"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Nyoni T, Okumu M. COVID-19-compliant strategies for supporting treatment adherence among people living with HIV in sub-Saharan Africa. AIDS Behav. 2020;24(9):2473\u20132476. https:\/\/doi.org\/10.1007\/s10461-020-02888-0","DOI":"10.1007\/s10461-020-02888-0"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Levac D, Colquhoun H, O\u2019Brien KK. Scoping studies: Advancing the methodology. Implementation Science. 2010;5(1):69. https:\/\/doi.org\/10.1186\/1748-5908-5-69","DOI":"10.1186\/1748-5908-5-69"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Arksey L, O\u2019Malley L. Scoping studies: Towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19\u201332. https:\/\/doi.org\/10.1080\/1364557032000119616","DOI":"10.1080\/1364557032000119616"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLOS Med. 2009;6(7):e1000097. https:\/\/doi.org\/10.1371\/journal.pmed.1000097","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref20","unstructured":"WHO. Men and HIV: Evidence-based approaches and interventions a framework for person-centred health services [homepage on the Internet]. 2023 [cited 2025 Feb 22]. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240085794"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Adeagbo O, Xulu Z, Gumede D, Naidoo K. Barriers and strategies to improve men\u2019s uptake of HIV care services in rural KwaZulu-Natal, South Africa: A qualitative approach. J Law Soc Dev. 2024;11:23. https:\/\/doi.org\/10.25159\/2520-9515\/14877","DOI":"10.25159\/2520-9515\/14877"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Pugh LE, Roberts JS, Viswasam N, et al. Systematic review of interventions aimed at improving HIV adherence to care in low- and middle-income countries in sub-Saharan Africa. J Infect Public Health. 2022;15(10):1053\u20131060. https:\/\/doi.org\/10.1016\/j.jiph.2022.08.012","DOI":"10.1016\/j.jiph.2022.08.012"},{"key":"ref23","unstructured":"UNAIDS. Male engagement in HIV testing, treatment and prevention in eastern and southern Africa: A framework for action [homepage on the Internet]. 2021 [cited 2025 Jul 20]. Available from: https:\/\/www.unaids.org\/en\/resources\/documents\/2022\/male-engagement-hiv-testing-treatment-prevention-eastern-southern-africa"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Orlando S, Palla I, Ciccacci F, et al. Improving treatment adherence and retention of HIV-positive women through behavioral change interventions aimed at their male partners: Protocol for a prospective, controlled before-and-after study. JMIR Res Protoc. 2021;10(1):e19384. https:\/\/doi.org\/10.2196\/19384","DOI":"10.2196\/19384"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Hlongwa M, Jama NA, Mehlomakulu V, Pass D, Basera W, Nicol E. Barriers and facilitating factors to HIV treatment among men in a high-HIV-burdened district in KwaZulu-Natal, South Africa: A qualitative study. Am J Mens Health. 2022;16(5):15579883221120987. https:\/\/doi.org\/10.1177\/15579883221120987","DOI":"10.1177\/15579883221120987"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Thurman TR, Luckett B, Zani B, Nice J, Taylor TM. Can support groups improve treatment adherence and reduce sexual risk behavior among young people living with HIV? Results from a cohort study in South Africa. Trop Med Infect Dis. 2024;9(7):162. https:\/\/doi.org\/10.3390\/tropicalmed9070162","DOI":"10.3390\/tropicalmed9070162"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Hlongwa M, Cornell M, Malone S, Pitsillides P, Little K, Hasen N. Uptake and short-term retention in HIV treatment among men in South Africa: The coach Mpilo pilot project. Glob Health Sci Pract. 2022;10(1):e2100498. https:\/\/doi.org\/10.9745\/GHSP-D-21-00498","DOI":"10.9745\/GHSP-D-21-00498"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Thorp M, Bellos M, Temelkovska T, et al. Mobility and ART retention among men in Malawi: A mixed-methods study. J Int AIDS Soc. 2023;26(3):e26066. https:\/\/doi.org\/10.1002\/jia2.26066","DOI":"10.1002\/jia2.26066"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Jiao K, Wang C, Liao M, et al. A differentiated digital intervention to improve antiretroviral therapy adherence among men who have sex with men living with HIV in China: A randomized controlled trial. BMC Med. 2022;20(1):341. https:\/\/doi.org\/10.1186\/s12916-022-02538-3","DOI":"10.1186\/s12916-022-02538-3"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Higa DH, Marks G, Crepaz N, Liau A, Lyles CM. Interventions to improve retention in HIV primary care: A systematic review of U.S. studies. Curr HIV\/AIDS Rep. 2012;9(4):313\u2013325. https:\/\/doi.org\/10.1007\/s11904-012-0136-6","DOI":"10.1007\/s11904-012-0136-6"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Jopling R, Nyamayaro P, Andersen LS, Kagee A, Haberer JE, Abas MA. A cascade of interventions to promote adherence to antiretroviral therapy in African countries. Curr HIV\/AIDS Rep. 2020;17(5):529\u2013546. https:\/\/doi.org\/10.1007\/s11904-020-00511-4","DOI":"10.1007\/s11904-020-00511-4"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Khang SAH, Cardona C. Interventions that can improve the retention in care among patients with HIV: A review. Am J Hosp Med. 2022;6(3):1\u20139. https:\/\/doi.org\/10.24150\/ajhm\/2022.010","DOI":"10.24150\/ajhm\/2022.010"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Nkomo G, Mosalo A, Thupayagale-Tshweneagae GB. Adherence to treatment and retention to care of adult patients on antiretroviral therapy. Afr J Nurs Midwifery. 2018;20(1):13. https:\/\/doi.org\/10.25159\/2520-5293\/1590","DOI":"10.25159\/2520-5293\/1590"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Sambayi GL, Bwire GM, Kilapilo MS, et al. Barriers and enablers to retention in HIV care and adherence to antiretroviral therapy: Evidence from Dar es Salaam, Tanzania. HIV\/AIDS. 2024;16:301\u2013311. https:\/\/doi.org\/10.2147\/HIV.S458545","DOI":"10.2147\/HIV.S458545"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Matimbwa H, Lolo SA, Matoy LS, et al. Factors contributing to retention in care and treatment adherence among people living with HIV returning to care in South-Eastern Tanzania: A qualitative study. HIV\/AIDS. 2025;17:39\u201357. https:\/\/doi.org\/10.2147\/HIV.S492673","DOI":"10.2147\/HIV.S492673"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Gilbert HN, Wyatt MA, Pisarski EE, et al. How community ART delivery may improve HIV treatment outcomes: Qualitative inquiry into mechanisms of effect in a randomized trial of community-based ART initiation, monitoring and re-supply (DO ART) in South Africa and Uganda. J Int AIDS Soc. 2021;24(10):e25821. https:\/\/doi.org\/10.1002\/jia2.25821","DOI":"10.1002\/jia2.25821"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Lippman SA, Pettifor A, Dufour MK, et al. A community mobilisation intervention to improve engagement in HIV testing, linkage to care, and retention in care in South Africa: A cluster-randomised controlled trial. Lancet HIV. 2022;9(9):e617\u2013e626. https:\/\/doi.org\/10.1016\/S2352-3018(22)00192-8","DOI":"10.1016\/S2352-3018(22)00192-8"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Mfecane S. Narratives of HIV disclosure and masculinity in a South African village. Cult Health Sex. 2012;14(suppl 1);S109\u2013S121. https:\/\/doi.org\/10.1080\/13691058.2011.647081","DOI":"10.1080\/13691058.2011.647081"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"Damulak PP, Ismail S, Abdul Manaf R, Mohd Said S, Agbaji O. Interventions to improve adherence to antiretroviral therapy (ART) in sub-Saharan Africa: An updated systematic review. Int J Environ Res Public Health. 2021;18(5):2477. https:\/\/doi.org\/10.3390\/ijerph18052477","DOI":"10.3390\/ijerph18052477"}],"container-title":["African Journal of Primary Health Care &amp; Family Medicine"],"original-title":[],"link":[{"URL":"https:\/\/phcfm.org\/index.php\/phcfm\/article\/view\/5309\/9533","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T10:33:13Z","timestamp":1784629993000},"score":1,"resource":{"primary":{"URL":"https:\/\/phcfm.org\/index.php\/phcfm\/article\/view\/5309"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/phcfm.v18i1.5309","relation":{},"ISSN":["2071-2928","2071-2936"],"issn-type":[{"value":"2071-2928","type":"print"},{"value":"2071-2936","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"article-number":"a5309"}}