Evaluating the Effectiveness of Peer-Led Counseling on Improving ART Adherence among Adolescents Living with HIV: A Randomized Control Study

Adolescents living with HIV (ALHIV) face unique challenges in adhering to antiretroviral therapy (ART), resulting in suboptimal health outcomes, including virologic failure and increased morbidity. Peer-led counseling has emerged as an innovative strategy to address these barriers, leveraging relatability and shared experiences to foster trust, empathy, and behavioral change. This review examined the effectiveness of peer-led counseling in improving ART adherence among adolescents, focusing on evidence from randomized controlled trials (RCTs). The methodology involved a narrative synthesis of existing literature to evaluate the impact of peer-led interventions and identify underlying mechanisms, implementation challenges, and future directions. Key findings from RCTs highlight significant improvements in ART adherence, viral suppression, and psychosocial outcomes, including reduced stigma and increased self-efficacy. Peer-led models were associated with additional benefits such as enhanced engagement and cost-effectiveness compared to traditional approaches. However, challenges remain, including the selection and training of peer counselors, ensuring program sustainability, and adapting interventions to diverse cultural contexts. Future research should explore integrating digital tools, engaging families, and assessing long-term impacts to optimize the scalability and effectiveness of peer-led interventions. Peer-led counseling represents a transformative approach to improving ART adherence, offering a promising pathway to better health outcomes for ALHIV. Keywords: Adolescents Living with HIV (ALHIV), Antiretroviral Therapy (ART) Adherence, Peer-Led Counseling, Randomized Controlled Trials (RCTs), Psychosocial Outcomes.