Brazil's comprehensive HIV treatment program does not specifically address ART adherence challenges for adolescents-a group accounting for the largest number of incident HIV infections in Brazil. We conducted three focus groups with 24 adolescents (age 15-24) living with HIV in Rio de Janeiro, separately for cisgender men who have sex with men, heterosexual-identified cisgender men and women, and transgender women of any sexual orientation, and key informant interviews (n = 7) with infectious disease specialists and HIV/AIDS service organization staff. Content analysis identified socioecological barriers and facilitators to adherence, including individual (e.g., low knowledge, side effects, and substance use), interpersonal (e.g., stigma from partners and health care providers) and structural (e.g., transportation and medication access) barriers. Overlapping and unique barriers emerged by sexual/gender identity. A community-informed, theory-driven ART adherence intervention for adolescents that is organized around identity and leverages social networks has the potential to improve HIV treatment and health outcomes for Brazilian adolescents.

中文翻译：

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发展基于社交网络的干预措施，以克服巴西青少年ART依从性的多层次障碍

巴西的综合性HIV治疗计划并未专门针对青少年的ART依从性挑战，该群体是巴西最大的HIV感染事件。我们在里约热内卢与24名15至24岁的艾滋病毒青少年进行了三个焦点小组讨论，分别针对与男性发生性行为的顺性别男性，异性恋者，以及具有任何性取向的跨性别女性，与传染病专家和艾滋病毒/艾滋病服务组织人员进行的知情者访谈（n = 7）。内容分析确定了遵守的社会生态障碍和促进因素，包括个人（例如知识不足，副作用和药物使用情况），人际关系（例如来自合作伙伴和卫生保健提供者的污名）和结构性（例如，运输和药物获取）障碍。性/性别认同产生了重叠和独特的障碍。以身份为中心并利用社交网络组织的针对青少年的社区知情，理论驱动的ART依从性干预措施有可能改善巴西青少年的HIV治疗和健康状况。