Socio-demographic Determinants of Anti-Retroviral Therapy Adherence in South Africa: A Systematic Review

Background: South Africa has the highest number of people on ART in the world and the number is increasing especially with the upward review of CD4 for the initiation of ART in positive persons. Considering this increasing number, there is increased effort to ensure adherence to ART. Despite this, the adherence of South Africans to ART is unsatisfactory and socio-demographic factors play a major role. To assess this association, we did a systematic review of literatures to determine the socio-demographic factors that impact ART adherence. Methods: PubMed, Cochrane, PLoS one, BMC, ProQuest and Google scholarwere searched to ascertain studies in South Africa from 2009 to 2014 on socio-demographic determinants of ART and selected 22 relevant articles for this review. Results: The results of the demographic determinants were inconsistent and depended on the population group, setting and the context of the patients.However, social factors at material, informational and emotional levels were consistent and necessary determinant of ART adherence in most settings. Conclusion: Social and demographic factors are necessary determinants of ART adherence. Social factors were alluded to in all studies reviewed as a necessary, enabling or sustaining factor through whichotherfactorsimpact adherence. The evidence in this review suggests that adherence to ART could be improved if social and material supportis available at all cadre of society.