Improving treatment adherence among people living with HIV through adherence counseling: a scoping review

HIV remains a major global public health challenge. Although antiretroviral therapy (ART) effectively reduces morbidity and mortality, its success depends on sustained adherence to treatment. Barriers such as stigma, psychosocial problems, and limited access to healthcare continue to compromise adherence among people living with HIV (PLHIV). Adherence counseling (AC) has been increasingly implemented to address these challenges and improve treatment outcomes. This study aimed to map and synthesize the types and effectiveness of AC interventions in improving ART adherence among PLHIV. A scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Literature searches were performed in Scopus, ScienceDirect, ProQuest, and PubMed using population, intervention, comparison, and outcomes-based keywords. Eligible studies evaluated AC interventions with ART adherence as an outcome and were published in the last 5 years. Of the 689 identified articles, 13 met the inclusion criteria. Most studies were conducted in Uganda and focused on intensive AC (IAC). IAC improves ART adherence and viral load suppression, particularly when delivered through structured, patient-centered approaches. However, the effectiveness varied according to social, health system, and contextual factors. Digital-based interventions, including real-time medication monitoring and mobile health applications, have also demonstrated promising effects on adherence. IAC plays an important role in improving ART adherence among PLHIV. Its effectiveness is influenced by the quality of counseling, social support, and health system integration. Combining face-to-face counseling with digital innovations and community-based support offers the most sustainable strategy for enhancing adherence and achieving viral suppression in PLHIV.