A Meta-Analysis of Structured Disclosure Interventions on Antiretroviral Therapy Adherence Amongst HIV-Affected Adolescents in Homa Bay County, Kenya

Adolescents living with HIV in high-prevalence settings such as Homa Bay County, Kenya, face considerable challenges in sustaining antiretroviral therapy (ART) adherence. Poor adherence risks treatment failure and worsened health outcomes. Structured disclosure of HIV status within affected households is a proposed intervention to improve adherence, but its effect requires consolidated evidence. This meta-analysis aimed to synthesise quantitative evidence on the effect of structured disclosure interventions on ART adherence amongst HIV-affected adolescents aged 10–14 years in Homa Bay County, Kenya. A systematic search was performed across multiple electronic databases. Included studies were randomised controlled trials, cohort studies, and pre-post intervention studies reporting adherence outcomes following a structured disclosure intervention. Study quality was assessed using standardised tools. Data were extracted and pooled using a random-effects model to calculate a summary effect estimate. The pooled analysis indicated that structured disclosure interventions were associated with a statistically significant improvement in ART adherence. The pooled odds ratio for optimal adherence in intervention groups compared to controls was 2.45 (95% CI 1.80–3.33). Structured disclosure interventions have a positive effect on ART adherence amongst HIV-affected adolescents in this context, supporting their integration into adolescent HIV care programmes. Healthcare policy in high-prevalence regions should consider integrating standardised, culturally adapted disclosure protocols into routine paediatric and adolescent HIV care. Further research is required to identify optimal delivery methods and ensure long-term sustainability. HIV, adolescents, antiretroviral therapy, adherence, disclosure, Kenya, meta-analysis This meta-analysis provides a consolidated evidence base on the effectiveness of a specific psychosocial intervention for a key population in a defined geographical setting.