African journal of AIDS research : AJAR最新文献

{"title":"Correlates of HIV pre- and post-exposure prophylaxis uptake among female university students in Uganda.","authors":"Ivan Segawa, Sabrina Bakeera-Kitaka, Lorraine Oriokot, Kenneth Ssebambulidde, Timothy R Muwonge, Kevin Ouma Ojiambo, Andrew Mujugira","doi":"10.2989/16085906.2025.2555200","DOIUrl":"10.2989/16085906.2025.2555200","url":null,"abstract":"<p><p>Female university students engaging in high-risk sexual behaviours, such as transactional sex or unprotected sex, are eligible for HIV pre- and post-exposure prophylaxis (PrEP/PEP). This study aimed to determine the uptake and correlates of PEP and PrEP use among female students at a public university in Uganda. We conducted an online survey among 483 female students at Makerere University and found that 53% had ever engaged in sexual intercourse, with a median debut of 20 years (interquartile range 18 to 22 years). Overall, 20% had sex with a person with HIV or of unknown status, and 9% experienced sexual assault. Despite 32% being eligible for PEP and 20% for PrEP, uptake remained low (9% and 2%, respectively). PEP use was associated with being married/cohabiting and perceived HIV risk. Low uptake of PrEP and PEP among eligible female students highlights the need for targeted awareness and accessibility efforts in academic institutions.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"197-204"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative analysis of compliance with HIV/AIDS clinical care indicators and treatment outcomes: A case study of the Democratic Republic of Congo and South Africa.","authors":"Tambwe Willy Muzumbukilwa, Riziki Ghislain Manimani, Rajesh Vikram Vagiri, Manimbulu Nlooto","doi":"10.2989/16085906.2025.2562859","DOIUrl":"https://doi.org/10.2989/16085906.2025.2562859","url":null,"abstract":"<p><p><i>Background</i>: Significant advancements have been made in human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) diagnosis and treatment, yet progress in quality care remains limited. To address this gap, 88 quality indicators for clinical HIV/AIDS care were evaluated. This study aimed to assess and compare adherence to these quality indicators and to analyse their impact on treatment outcomes in the Democratic Republic of Congo (DRC) and South Africa (SA).<i>Methods</i>: A retrospective cohort study was conducted at Panzi Hospital (DRC) and King Edward VIII Hospital (SA) among adult HIV and AIDS (PLWHA) patients who began antiretroviral treatment between January 2018 and December 2022. Descriptive analysis and logistic regression were used to assess the association between indicators and treatment outcomes.<i>Results</i>: Compliance with indicators was 65.75% in the DRC and 69.86% in SA. Multivariate analysis identified 10 indicators in DRC and four in SA linked to negative immunological responses, while eight in the DRC and seven in SA were associated with viral load suppression failure. Additionally, 12 indicators in the DRC and 14 in SA were linked to an increased risk of death.<i>Conclusion</i>: The level of compliance with the indicators was suboptimal in both countries, indicating the need for improvement. Several indicators were associated with treatment outcomes.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":"24 3-4","pages":"142-161"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility, challenges, and lessons learned in implementing antiretroviral adherence club models in Northern Tanzania.","authors":"Ramadhani Abdul, Lukas Van Duffel, Giulia Martelli, Edda Ndyamukama Joel, Joyce Zacharia Misesemo, Tobias F Rinke de Wit, Sayoki Mfinanga, Anton Pozniak, Sabine Hermans","doi":"10.2989/16085906.2025.2577800","DOIUrl":"https://doi.org/10.2989/16085906.2025.2577800","url":null,"abstract":"<p><p><i>Introduction</i>: In Tanzania, nearly 1.6 million adults were living with HIV in 2022, with an HIV prevalence rate of 4.4%. We piloted community health worker-managed adherence clubs in two clinics in Shinyanga, Tanzania. We previously demonstrated better stability in care and improved treatment adherence following the establishment of clubs. This study evaluated referral back to the facility, feasibility, and challenges to inform potential scale-up.<i>Method</i>: The study included clubs from two clinics between July 2018 and September 2019, Ngokolo (13 clubs) and Bugisi (33 clubs), all located in the Shinyanga region. Clinicians invited stable clients to join an AC if they met eligibility criteria. Logistic regression models identified factors associated with the likelihood of clients' referral back to the facilities<i>Results</i>: The setup of the adherence clubs was feasible and successful. In one year, 46 clubs with 617 clients were established. Thirty-eight clients (6.3 %) were referred back to the clinics. Factors associated with being referred back were lower age (below 25 compared to above), having ever missed AC visits, and a rural site. Challenges included start-up problems with wrongful enrolments, the need for additional staff to facilitate the club model, the duplication of data collection tools, and the need for youth-friendly adherence clubs.<i>Conclusion</i>: Task shifting to community health workers to manage the clubs was successful. Despite its success, it required a higher level of organisation, particularly during the setup phase. These findings support the revision of the National HIV guideline to formally integrate community health worker-led adherence clubs, ensuring scalability and sustainability.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":"24 3-4","pages":"97-106"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to PrEP for cis and transgender women: Developing and implementing a community-based intervention adapted to populations exposed to HIV in Mali, Morocco, and Mauritius.","authors":"Mustapha Sodqi, Amal Ben Moussa, Rosemary Delabre, Rime Barrakad, Luis Sagaon Teyssier, Niloufer Khodabocus, Sofia Fathi, Fodié Diallo, Patrice Monvoisin, Bintou Keita Dembele, Annette Treebhoobun, Naoual Laaziz, Lahoucine Ouarsas, Daniela Rojas Castro, Mehdi Karkouri","doi":"10.2989/16085906.2025.2555202","DOIUrl":"10.2989/16085906.2025.2555202","url":null,"abstract":"<p><p><i>Background</i>: Pre-exposure prophylaxis (PrEP) is recommended as part of a comprehensive HIV prevention approach, but its uptake among women, particularly those in key populations, remains limited.<i>Methods</i>: A mixed-methods community-based study was conducted in Mali, Mauritius, and Morocco to assess barriers and facilitators to PrEP implementation among cis and transgender women at high risk of HIV infection. Quantitative data collected included demographic information, awareness, willingness to use PrEP, and perceived barriers. The qualitative component included in-depth interviews with key populations, policymakers, healthcare workers, and community stakeholders to better determine the barriers to PrEP implementation and scale-up for women. Data analysis and processing were performed using software adapted to the respondent-driven sampling technique.<i>Results</i>: Between 15 February and 15 March, 2020, a survey was conducted involving 1 003 female participants. The results indicated varying levels of awareness of PrEP across different populations, with transgender women in Mauritius exhibiting the highest awareness (54%). Moreover, there was generally a high willingness to use PrEP among participants, with rates of 77% and 84% among female sex workers in Morocco and Mali, respectively, and 71% among female partners of people who inject drugs, as well as 50% among transgender women in Mauritius. Additionally, qualitative insights revealed prevailing barriers such as issues related to accessibility, stigma, and the legal frameworks in the respective countries.<i>Conclusion</i>: This study provides critical insights into the challenges and opportunities for PrEP implementation among women in Mali, Mauritius, and Morocco. The findings underscore the importance of community-based research and the need for tailored interventions to improve PrEP awareness and uptake among women, particularly those in key populations. The results may inform advocacy efforts and the provision of adapted services within comprehensive HIV prevention programs to better address the needs of these populations.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"128-141"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial predictors and gender differences in the mental well-being of adolescents living with HIV in Ibadan, Nigeria.","authors":"Ezekiel O Aruoture, Abel C Obosi","doi":"10.2989/16085906.2025.2589741","DOIUrl":"10.2989/16085906.2025.2589741","url":null,"abstract":"<p><p><i>Background</i>: The psychosocial vulnerability of adolescents living with HIV, particularly in sub-Saharan Africa, where structural and psychosocial stressors are prevalent, is an important public health concern. While several studies have investigated some psychosocial factors as they predict mental well-being among adults living with HIV, little is known about the role of psychosocial (depression, personality traits and social support) predictors and sex differences in the mental well-being of adolescents living with HIV in Ibadan, Nigeria.<i>Aim</i>: This study aims to examine the psychosocial predictors and gender differences in the mental well-being of adolescents living with HIV in Ibadan, Nigeria.<i>Methods</i>: A cross-sectional design using purposive sampling was employed, with data collected from 144 adolescents (aged 13 to 19 years, <i>M</i> = 16.04 years, SD = 2.02 years). Instruments included the Warwick-Edinburgh Mental Well-being Scale, the Perceived Social Support in HIV (PSS-HIV) scale, the Centre for Epidemiologic Studies Depression Scale (CESD-R) Scale, and the Big Five Personality Traits inventory. Five hypotheses were tested using hierarchical multiple regression and an independent sample <i>t</i>-test at a significance level of 0.05.<i>Results</i>: Results showed that depression, personality traits, and social support jointly predicted mental well-being [<i>F</i>(12, 122) = 13.77, <i>R</i> = 0.60, <i>R</i>² = 0.36, <i>p</i> < 0.01]. Independent predictors included agreeableness (<i>β</i> = 0.23, <i>t</i> = 2.54, <i>p</i> < 0.01), openness (<i>β</i> = -0.19, <i>t</i> = -2.05, <i>p</i> < 0.05), belonging (<i>β</i> = 0.22, <i>t</i> = 2.56, <i>p</i> < 0.01), and esteem (<i>β</i> = 0.38, <i>t</i> = 3.31, <i>p</i> < 0.001). Results also showed that there were no significant sex differences in mental well-being [<i>t</i>(141) = -1.39, <i>p</i> > 0.05].<i>Conclusion</i>: Psychosocial factors significantly influenced mental well-being, and interventions should focus on strengthening social support networks and promoting adaptive personality traits to improve mental well-being.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"107-119"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors driving pre-exposure prophylaxis uptake among students at six Gauteng province universities: An application of Pender's Health Promotion Model.","authors":"Paul Potsane, Charlene Downing, Patrick Ndayizigamiye","doi":"10.2989/16085906.2025.2573985","DOIUrl":"10.2989/16085906.2025.2573985","url":null,"abstract":"<p><p><i>Background</i>: South Africa has the world's highest HIV prevalence rate (12.7%), with university students disproportionately affected. While HIV Pre-Exposure Prophylaxis (PrEP) is an effective preventive measure for high-risk individuals, its uptake among university students remains low, which hinders progress toward national and global targets to end the AIDS epidemic by 2030. This study aimed to identify the factors influencing PrEP uptake in this vulnerable population, specifically among university students in Gauteng province, using Pender's Health Promotion Model.<i>Methods</i>: A quantitative, descriptive cross-sectional survey was conducted among 537 university students across six universities in Gauteng province. Data were analysed using Partial Least Squares Structural Equation Modelling to identify significant predictors of PrEP use.<i>Results</i>: The study revealed a low PrEP uptake rate among students at risk of contracting HIV. The analysis identified several factors that directly influenced PrEP uptake, including knowledge (<i>β</i> = 0.122, <i>p</i> = 0.001), interpersonal influence (<i>β</i> = 0.082, <i>p</i> = 0.038), situational influence (<i>β</i> = 0.145, <i>p</i> = 0.001), and perceived benefits (<i>β</i> = 0.121, <i>p</i> = 0.003). Significant interactions were also found between condom use and knowledge (<i>β</i> = 0.098, <i>p</i> = 0.004) and between condom use and perceived benefits (<i>β</i> = 0.127, <i>p</i> = 0.013).<i>Conclusion</i>: PrEP uptake is a complex process influenced by the dynamic interplay of factors consistent with Pender's Health Promotion Model, particularly interpersonal, cognitive, and situational factors. These results provide valuable evidence for developing multifaceted, youth-friendly interventions, such as a mobile health application, to promote PrEP use, reduce HIV incidence, and help achieve national and global HIV prevention targets.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"171-183"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of viral suppression among young people living with HIV and on antiretroviral therapy in Eswatini: A cross-sectional study.","authors":"Thabile P Simelane, Emeka F Okonji, Brian E van Wyk","doi":"10.2989/16085906.2025.2566144","DOIUrl":"10.2989/16085906.2025.2566144","url":null,"abstract":"<p><p><i>Background</i>: HIV treatment, adherence, and retention in care are fundamental in achieving viral load suppression (VLS) and fighting the HIV pandemic. The Government of Eswatini has decentralised antiretroviral treatment (ART) services and introduced differentiated HIV service delivery models to improve treatment outcomes for all people living with HIV, including young people. It is imperative to investigate the success of these initiatives in improving VLS in young people living with HIV (YPLHIV) in Eswatini.<i>Objective</i>: To determine the factors associated with VLS amongst YPLHIV (15 to 24 years) who are on ART in Eswatini.<i>Methodology</i>: A retrospective cohort analysis of 4 334 YPLHIV on ART in Eswatini between January 2018 and December 2021 was conducted. The Statistical Package for Social Scientists version 25 was used to determine the factors associated with viral suppression through bivariate and logistic regression analysis.<i>Results</i>: The prevalence of viral suppression (< 1 000 copies/mL) was 92.9%. After adjusting for all covariates, the likelihood of viral suppression remained significantly higher among YPLHIV who were female (AOR = 2.06; CI 1.04-4.11), had enrolled on the fast-track ART care model (AOR = 2.14; CI 1.09-4.20), and were receiving 4 to 5 months' (AOR = 5.88; CI 3.14-11.02) and 6+ months' (AOR = 3.55; CI 1.67-7.53) of medication.<i>Conclusion</i>: The national HIV treatment program in Eswatini exceeded the UNAIDS target of 90% virologic suppression for YPLHIV who are enrolled for ART for more than six months. However, to meet the revised 95% target, tailored interventions are required to strengthen long-term adherence and retention in care for YPLHIV on ART.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"162-170"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal Health Service Coverage under threat? A study of the effects of PEPFAR HIV funding on UHC.","authors":"Lazarus Muchabaiwa, Charles Birungi, Melissa Sobers, Jaime Atienza Azcona","doi":"10.2989/16085906.2025.2577377","DOIUrl":"https://doi.org/10.2989/16085906.2025.2577377","url":null,"abstract":"<p><p><i>Introduction</i>: While the effects of the US government's sudden pause of foreign aid on the global HIV response have been well documented, little is known about the likely impact on universal health coverage (UHC) in recipient countries. This study assesses the association between PEPFAR funding and the universal health service coverage index.<i>Methods</i>: Using data on PEPFAR investments in 24 countries between 2004 and 2020, the study applied fixed and time effects panel data regression on the main UHC index and its sub-indices for non-communicable diseases (NCDs), reproductive, maternal, newborn and child healthcare (RMNCH); and service capacity and access. Gross domestic product (GDP) per capita, government health expenditure as a percentage of current health expenditure (CHE), private health expenditure as a percentage of CHE, and government efficiency were included as control variables.<i>Results</i>: The UHC index tripled in some countries over the study period, coinciding with PEPFAR investments, which prioritised HIV treatment. However, GDP per capita doubled, government health spending increased marginally, while out-of-pocket payments declined in the same time period. The study found positive associations between PEPFAR funding and the UHC index (0.11, <i>p</i> < 0.01), RMNCH (0.036, <i>p</i> < 0.1), and NCDs (0.038, <i>p</i> < 0.05). GDP per capita, government health expenditure, and government efficiency were also positively associated with UHC indexes. Time effects were established for the main UHC index and the NCDs sub-index.<i>Conclusions</i>: We conclude that PEPFAR funding for HIV was instrumental in driving UHC in recipient countries. The abruptness of the funding cuts was destabilising to HIV programs across the globe and threatened to upend hard-won gains in ending AIDS as a public health threat. Without renewed PEPFAR support, continued global solidarity, and greater domestic financing, health systems risk setbacks threatening the health of current and future generations, as well as global health security. Safeguarding current progress requires PEPFAR funding restoration, host governments' commitment to growth-oriented policies, efficient use of available resources, integration of HIV into UHC, stronger South-South cooperation to reduce aid reliance, and donor alignment with national health goals.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":"24 3-4","pages":"87-96"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV status disclosure and antiretroviral therapy adherence among children in Masaka region, Uganda.","authors":"Robert Kairania,&nbsp;Washington Onyango-Ouma,&nbsp;Tom G Ondicho,&nbsp;Godfrey Kigozi","doi":"10.2989/16085906.2022.2060843","DOIUrl":"https://doi.org/10.2989/16085906.2022.2060843","url":null,"abstract":"<p><p>HIV-infected children are now living into adolescence and early adulthood in large numbers due to the availability and increased use of antiretroviral therapy (ART). However, receipt of HIV status disclosure among children remains low. We assessed the association between disclosure of HIV status and adherence to ART among children in the Masaka region of Uganda using multivariable logistic regression with generalised linear models with Poisson log-link function and robust variance in Stata software version 15.1. Data were collected from 524 assenting children aged 12-17 years between March and December 2020. Results show that, although not statistically significant, children who received disclosure of their HIV status reported improved ART adherence compared to children with no disclosure. Out-of-school children with post-primary education and children on first-line ART regimens were significantly more likely to report improved ART in both crude and adjusted analyses. Innovative interventions to promote progressive disclosure of HIV status to children on ART, in school, are needed to improve their ART adherence. There is also a need to evaluate the suitability of current counselling interventions provided to children being switched to second-line ART regimens to delay the need for third-line ART regimens.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"251-260"},"PeriodicalIF":1.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40362898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring how outreach team leaders perceive community health workers' experiences of providing HIV services in KwaZulu-Natal, South Africa.","authors":"Gugulethu E Khumalo,&nbsp;Elizabeth Lutge,&nbsp;Tivani P Mashamba-Thompson","doi":"10.2989/16085906.2022.2060841","DOIUrl":"https://doi.org/10.2989/16085906.2022.2060841","url":null,"abstract":"<p><p><i>Objectives:</i> In 2018, the KwaZulu-Natal Department of Health launched the ward-based primary health care outreach teams policy framework which sought to expand the community health worker (CHW) programme's provision of longitudinal patient support, including human immunodeficiency virus (HIV) services in communities. This study sought to explore the perceptions of outreach team leaders who supervise CHWs on their experiences of providing HIV services in the province.<i>Study design:</i> This was a qualitative, phenomenology study.<i>Methods:</i> Convenience sampling was done to select one outreach team leader from each of the 11 KwaZulu-Natal health districts to be interviewed using an interview guide. Thematic analysis, guided by the Ritchie and Spencer framework analysis, was used to analyse the data.<i>Results:</i> The challenges faced by CHWs in delivering HIV services were: the absence of individuals when CHWs visited their homes, self-HIV stigma, rejection of CHWs' HIV services due to traditional beliefs, CHW shortages, lack of other resources, low levels of CWH education and a lack of training. On the other hand, the provision of HIV services was fascilitated by: supportive supervision, training, having cell phones and having a positive attitude towards providing HIV services by CHWs that were HIV-positive.<i>Conclusion:</i> The CHWs in KwaZulu-Natal face more challenges than enablers in the provision of HIV services. The delegation of HIV services to CHWs should be aligned with their holistic empowerment by eliminating barriers to the provision of HIV services.</p>","PeriodicalId":520548,"journal":{"name":"African journal of AIDS research : AJAR","volume":" ","pages":"239-250"},"PeriodicalIF":1.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40356507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}