Enactment of Gender Roles and Their Implications on Viral Load (VL) Testing Appointments and Drug Adherence among Adolescent Boys on Anti-Retro-Viral Therapy (ART) in Siaya County of Kenya

Abstract

There has been a significant decline in HIV-related deaths by 51%, down from between 970 000 and 1.8 million in 2010 to approximately 630 000 in 2022 except for the adolescent boys. Viral Load testing and drug adherence are recommended to monitor ART failure and reduce HIV-related mortalities. Whereas gender norms ascribe specific roles to men, which have been documented to have negative outcomes on their health, whether this has also extended to adolescent boys and affected their VL testing appointments and drug adherence remains underexplored. This insight is significant in high HIV prevalence areas that have recorded differentials in HIV-related deaths among this population, such as Siaya County of Western Kenya. This paper used a cross-sectional survey to investigate the implications of gender role enactment on VL testing and drug adherence among adolescent boys on ART in Siaya County, Kenya. A sample of 263 boys on ART was interviewed, and two focus group discussions and in-depth interviews were held with the boys, while three key informant interviews were conducted with healthcare practitioners and government officers. Enactment of gender roles has been found to interfere with the uptake of VL testing and drug adherence since the boys often take up tough manual jobs to fend for the family as a priority over medication. It is concluded that the breadwinner role being played by the boys seriously affects the honouring of VL testing and taking of ART drugs; hence, interventions aimed at cushioning the families housing the boys should be initiated.