Dynamics of HIV treatment practices, trends, challenges and future prospects: A structured narrative review

Abstract

The global response to the scourge of HIV/AIDS has improved significantly over the decades, marked by developments in antiretroviral therapy (ART), advancements in treatment policies, and progress in battling the challenges associated with adherence and access to treatment. This study conducted a narrative review of the Dynamics of HIV/AIDS treatment practices, trends, challenges, and prospects. The study was a narrative review of literature. We searched for articles using three databases: PubMed, Medline, and Google Scholar, from 2000 to January 2025. Studies without clearly defined period, duration, sample size, and location were discarded. International policies significantly impacted access to ARVs by influencing market dynamics, reducing costs, and enhancing access for low-income countries. There was a decline in HIV new infections in Europe, but there are still challenges with drug resistance and the management of co-infections. Non-adherence to ART is commonly associated with certain psychosocial factors such as depression, lack of social support, and stigma; these factors affect patient outcomes. Depression was a major predictor of ART non- adherence, requiring mental health interventions. Adequate mental support may improve treatment outcomes for HIV- positive patients. Non-adherence to ART, under-staffing, inadequate infrastructure, and poor access to medicines impact negatively on ART. Integrated efforts aimed at tackling HIV related psychosocial challenges such as stigma, mental health, and emerging threats like ART misuse and drug resistance are pivotal areas for future interventions. Long distances to healthcare facilities, systemic or administrative barriers, poor inter professional collaboration also affected patients' response to treatment. By strengthening patient-centered care and integrating mental health and substance abuse services into ART, it is possible to create a more equitable, better optimized, and effective treatment environment for PLHIV.