Navigating Multifaceted Barriers: A Qualitative Exploration of Antiretroviral Therapy Adherence Among Hispanic People with HIV in Texas

HIV remains a significant public health concern, particularly among Hispanic individuals living with HIV (PWH) in Texas. Despite advancements in antiretroviral therapy (ART), adherence to medication regimens continues to be a challenge due to limited access to healthcare. This qualitative study aims to explore the multifaceted barriers that hinder ART adherence among Hispanic PWH in Texas, providing a comprehensive understanding of the challenges faced by this population and informing targeted interventions. We conducted semi-structured interviews, each lasting approximately 30 to 40 min, with 13 participants recruited from both outpatient and inpatient settings. Interviews were conducted by members of our bilingual research team. Data were analyzed using grounded theory to identify key themes related to adherence challenges, including stigma, healthcare navigation, and socioeconomic factors. The analysis revealed six major themes impacting adherence, with the following distribution based on the percentage of coded references: Health Management and Medication Effects (35.5%), Education and Empowerment (23.9%), Coping Strategies and Adjustment (17.5%), Stigma and Disclosure (10.1%), Social Support and Connection (7.2%), and Access and Affordability (5.8%). Participants highlighted the physical and emotional challenges of managing ART, the role of education in adherence, and the significant impact of stigma and financial barriers. The findings show the complexity of ART adherence among Hispanic PWH in Texas, revealing the need for culturally tailored interventions that address the stigma, healthcare access, and social support. Enhancing education, strengthening support networks, and reducing financial barriers are important steps toward improving ART adherence and health outcomes in this population.