Effectiveness of Antiretroviral Therapy in People Living with HIV: A Narrative Literature Review of Clinical Outcomes, Adherence, and Psychosocial Determinants

Antiretroviral Therapy (ART) is the primary strategy for controlling HIV infection because it suppresses viral replication, improves immune status, and reduces morbidity and mortality among people living with HIV (PLWH). However, treatment success is not determined solely by pharmacological efficacy but is also influenced by treatment adherence, psychosocial factors, and healthcare system support. This study aimed to analyze the effectiveness of antiretroviral therapy among PLWH by synthesizing scientific evidence on clinical outcomes, treatment adherence, psychosocial determinants, and the effectiveness of different ART regimens. A narrative literature review was conducted on 30 articles retrieved from Scopus, PubMed, and Google Scholar, encompassing various study designs, including cross-sectional, cohort, retrospective, prospective, systematic review, meta-analysis, and longitudinal studies. Data were synthesized thematically based on clinical outcomes, treatment adherence, psychosocial determinants, and ART regimen effectiveness. The findings showed that ART consistently achieved viral load suppression and increased CD4 cell counts as indicators of virological and immunological success. Dolutegravir (DTG)-based regimens demonstrated better virological effectiveness than conventional ART regimens. Treatment adherence was positively influenced by patient knowledge, education, healthcare professional support, pharmaceutical care, and mHealth-based interventions, whereas depression and HIV-related stigma were associated with lower adherence. Overall, ART was effective in improving clinical outcomes among PLWH, while long-term treatment success was also influenced by adherence and psychosocial factors. These findings support the importance of optimizing ART regimens and providing continuous adherence and psychosocial support to sustain treatment effectiveness and maintain long-term viral suppression among PLWH.