“They are like poems in the entrance area”: Using photo-story posters to improve medication adherence among people with HIV

Although adherence to antiretroviral therapies can save lives and reduce HIV transmission, people living with HIV (PLH) struggle to understand medication adherence instructions and integrate instructions into their lives. We harnessed the power of photo-stories to create meaningful and effective adherence education posters for patients at an HIV clinic in urban Missouri.

16 PLH captured their adherence experiences with pictures and small group discussions and created ten educational posters with photo-stories. Posters were displayed in the clinic for three months and viewed by 200 different patients. Pre-posttest questionnaires and interviews evaluated the posters’ ability to address adherence attitudes and communication with providers among PLH who created and viewed the posters at baseline and three months follow-up.

In pre-posttest comparisons poster-creators reported higher levels of self-efficacy (P<.05) for adherence; poster-viewers (N=54) reported less reliance on others to take medications (P<.05). Viewers also remarked that the posters were relatable, inspiring, and understandable – and that they reinforced adherence and the importance of seeking adherence help.  One viewer noted, “The posters talk to you in a different way than what our providers can teach us. This is real. [People on posters] understand, know and deal with [adherence].”

Photo-stories are an effective way to design adherence education posters and promote adherence among those who create and view materials. PLH relate to the experiences of others and feel inspired to start or remain adherent and seek help, through personal images and stories. Eye-catching, informative, and relatable posters can enhance adherence and improve health among PLH.