Snapshots of adherence: Photo-stories capture medication motivators among people with HIV

Adherence to anti-retroviral therapy (ART) improves health and can reduce HIV transmission – yet many people living with HIV (PLH) report suboptimal medication use. We conducted a pilot study to explore the feasibility and use of photo-stories – pictures to identify, discuss, and share personal adherence motivators and challenges – as a potential adherence intervention strategy among PLH.

Participants photographed adherence experiences; shared pictures in three small group, and one individual, discussion session, and; chose pictures and captions to display publically in the clinic study site. To assess preliminary project impact, we analyzed session transcripts and 100 photographs using theme analysis strategies.  

Participants were 16 (10 women) low-income PLH who resided in a city in the Midwest, US. Key discussion themes revolved around motivations to become and remain adherent –important people or things, spirituality, hopefulness about the future, and adherence as a way to take control over one’s health.  Images of themes were varied and included medication routines, support systems, pets, self-portraits, and nature.  

Photo-stories are a feasible and appropriate tool to help PLH identify and discuss reasons to be adherent and how to surmount challenges. The project helped participants reflect on why they were committed to adherence and share strategies to manage barriers like the stigma of taking medicines. Our findings suggest that directing photo-stories towards capturing adherence motivators is a potential adherence intervention strategy worthy of further development.  Photo-stories can potentially support adherence behavior among the photographers and PLH who see the pictures.