Family caregivers motivations and behavioral strategies for enhancing retention on antiretroviral treatment among school-age children living with HIV in Ghana: a qualitative study.

Family caregivers play a central role in maintaining adherence, yet their experiences, motivations, and behavioral strategies remain underexplored in low-resource settings like Ghana. This qualitative study explores the motivations and behavioral strategies family caregivers employ to enhance retention on ART among school-age children living with HIV. A total of 17 family caregivers were recruited from a pediatric HIV clinic in Ghana through a purposive sampling approach. Semi-structured interviews were conducted, and data were analyzed using thematic analysis. Two key themes emerged: (1) Family caregiver motivation and commitment, where family caregivers were deeply engaged in ensuring ART adherence, driven by knowledge of ART benefits, family support, expectations, and positive relationships with healthcare workers; and (2) family caregiver behavioral skills, which included daily administration routines, problem-solving, managing child reluctance, medication concealment to avoid stigma, and planning for future disclosure of the child’s HIV status. This study revealed that successful pediatric ART adherence relies on two crucial elements: Family caregiver motivation and behavioral skills. The findings underscore the complex role family caregivers play in managing their children’s HIV treatment.