Predictors of non-adherence to antiretroviral therapy among postpartum women living with HIV in LMICs: a scoping review

This scoping review aims to explore what is known about the predictors of non-adherence to antiretroviral therapy in postpartum women living with HIV in low- and middle-income countries. The evidence identified in this review will inform the development of a tool to predict non-adherence to long-acting injectables in postpartum women in sub-Saharan Africa. Our participants, concept, and context are defined as follows: Participants We are specifically interested in evidence of postpartum women living with HIV who have initiated or been offered antiretroviral therapy. Due to an expected paucity of evidence in this population we plan to extend our inclusion criteria to women and adolescent girls with HIV infection who have initiated or been offered antiretroviral therapy. Adolescence is defined by the World Health Organisation as the period between 10 and 19 years of age (WHO 2025). We will utilise study-specific definitions of adolescence where reported or utilise the WHO definition if needed. Concept Predictors of non-adherence to HIV therapy, including reported barriers to initiation or adherence. Context Low-and middle-income countries, particularly sub-Saharan Africa. We will search for the following sources of evidence: This scoping review will consider experimental study designs including randomized controlled trials and non-randomized controlled trials. In addition, analytical observational studies including prospective and retrospective cohort studies, case-control studies, and analytical cross-sectional studies will be considered for inclusion. This review will also consider descriptive observational study designs including case series, individual case reports, and longitudinal studies for inclusion. Qualitative studies will also be considered, and reference lists of relevant systematic reviews or scoping reviews will be used to identify relevant sources of primary evidence. This scoping review is intended to support the development of a screening tool to predict the risk of non-adherence to long-acting injectables for HIV in postpartum women in sub-Saharan Africa. To support this, we will perform a sub-group analysis, presenting evidence specifically pertaining to this population.