Antiretroviral therapy adherence interventions among persons who use alcohol and other substances in fisherfolk communities: A systematic review

Background: Suboptimal adherence to antiretroviral therapy (ART) is a major challenge in Human Immunodeficiency Virus (HIV) treatment interventions among persons who use alcohol and other substances (AOS) in fisherfolk communities. While studies have identified barriers to ART adherence and interventions to address these barriers in this population, no systematic review has been conducted to establish the significance of these interventions. Methods: Searches were conducted in three electronic databases: PubMed, Web of Science and PsycINFO for studies conducted in English between 1996 and April 2024 to identify relevant primary studies that included adult males or females, engages in fishing activities, use alcohol or other substances and are HIV positive. Outcomes include any measure of adherence to ART, a reduction or abstinence from alcohol and other substance use and associated consequences that could hinder ART adherence. Results: 54 studies were identified and screened against the inclusion/exclusion criteria. Five papers met the inclusion criteria (three quantitative designs, one qualitative design and one mixed methods design). Seven interventions were identified, these include counselling, peer support, screening and brief intervention, economic straightening, social network, gender transformative programmes and prescription monitoring. Conclusion: Findings highlight the significance of alcohol use reduction interventions and gender transformative programmes particularly among men to encourage ART adherence in fisherfolk communities. To achieve the universal target of an end to the HIV scourge by 2030, specific hard to reach populations like fisherfolk communities with high HIV prevalence, alcohol and other substance use needs particular attention.