Understanding Knowledge Gaps and Challenges in Antiretroviral Adherence Among People Living with HIV in India: A qualitative investigation

India’s National AIDS and STD Control Program has expanded the treatment services through increased of Antiretroviral Therapy (ART) centres. However, ART nonadherence remains a significant challenge in achieving optimal treatment outcomes among people living with HIV (PLHIV). This study explored the treatment knowledge gaps and barriers to ART adherence. A descriptive-interpretive qualitative research approach was employed comprising of four focus group discussions (FGDs) involving 21 purposively selected PLHIV and key informant interviews (KIIs) with 8 HCP from two government ART centers in Central India. Thematic analysis identified inadequate knowledge about the disease and treatment, ART side effects, economic constraints, social stigma and discrimination, and healthcare system gaps as key barriers. Suggested strategies included accurate health education, convenient ART access, technology-assisted recall mechanisms and stronger family, social and workplace support. These findings highlight the need for multimodal interventions to improve treatment literacy and strengthen ART adherence in resource-limited settings.