“A task to reach undetectable”: Gaining the motivation to take their HIV care seriously
failure to suppression
SAID
As the most salient theme, youth described how Project YES! had inspired them to be mindful of their HIV care. Most described taking their medication inconsistently before the project—they were “not paying attention” and “didn’t really care”—but many described improvements through the project. As a 16-year-old male participant explained, “I am concerned about my health…When I get home, I no longer forget [to take my medication]. I manage everything.” Among the subset sampled whose viral load went from failure to suppression, most gave examples of how their viral load had gone down since participating in Project YES!, which had encouraged them to remain diligent with their ART. “Project YES! has…given me a task to reach undetectable,” said a 21-year-old male participant. A few youth explained that their family members no longer needed to “force” them to take their medication since they now had the self-motivation to carry through with the task.The youth also described increased motivation to take care of themselves in other ways. Many, for instance, described learning about nutrition as it relates to their health. They learned about the importance of eating a balanced diet and consuming sufficient food to support ART adherence—i.e., “foods which can help us to have energy so that this medicine can work in our bodies” (female, 21 years). A 23-year-old explained how she used to feel “that diet was not necessary,” but “from the time I started attending this [program], I am able to know…if I don’t eat right…my health will be affected. And since then, my health has been better.”Youth attributed their increased motivation for self-care to a combination of factors. For most, the knowledge gained from the program enhanced their motivation for self-care. They learned, for instance, the importance of taking their ART medication “properly” and “on time” because “we know the effects of not doing so.” Many gained practical skills to apply in their daily lives. They cited strategies for taking their medication (e.g., setting an alarm, keeping a record/diary) and managing their stress. A 19-year-old male participant, for example, described the importance of factoring his medication intake into his daily schedule; if he knew he is due for his medication at 20 hours but was leaving home at 19 hours and was unsure of his plans, he should bring the medication with him.Youth also highlighted the supportive role of the YPM and HCP and their recognition of the difficulties that youth face; as a 17-year-old female participant explained, “They tell us…every person has a challenge…. I’m grateful because I did not know that they would be this encouraging to me.” In particular, the youth described the benefits of meeting with a YPM who was also living with HIV and only slightly older than them. It made them feel “comfortable” sharing information about their lives and the challenges they face, knowing that the YPM would “understand more” than someone who was not living with HIV. According to a 21-year-old male participant, “If you are opening the secret to someone who is in the same situation as you, it just comes out easily, with no hesitation, fear, or embarrassment.” Finally, the youth developed future aspirations. They learned that every person has a right to marry, no matter their HIV status, and that it is possible to avoid giving HIV to a partner and to a baby. This knowledge allowed them to envision healthy future lives with their HIV status.