Antiretroviral Therapy and Program Retention in Urban Slums

Abstract

While the evidence suggests that HIV rates are higher in most urban areas there has been little research into the relative prevalence of HIV in urban slums or the dynamics of HIV in slum settings. The United Nations Human Settlement Program (UNHABITAT) states that slum dwellers have worse health outcomes and are at an increased risk of HIV compared to the general population. HIV care is more readily accessible in urban areas; however populations living in highly stressed urban environments may have more barriers to HIV care and treatment adherence. Well-described barriers to HIV care such as cost wait times malnutrition alcohol abuse and low health literacy may be exacerbated in these settings. The need for high adherence to antiretroviral therapy (ART) to avoid the development of drug resistance is a major concern in sub-Saharan Africa. This paper focuses on the HIV treatment data and adherence strategies from studies conducted in challenging living conditions in an effort to support program planning and resource allocation.