Although South Africa has the largest cohort worldwide initiated onto ART, we need to ask whether adequate attention has been given to ensuring long-term adherence to treatment. If the South African ART programme is to achieve the declared goal of the South African National Department of Health (i.e. to end the HIV epidemic by 2030), then – poor adherence to ART – must be recognised and addressed. The focus of this monograph is primarily on how social and structural factors shape and sustain the HIV epidemic, including their influence on adherence, and the implication of this for promoting adherence. We argue that dominant ways of thinking about adherence may themselves be problematic and we suggest alternative approaches.
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