Antiretroviral therapy (ART) aims to reduce HIV transmission, morbidity and mortality and to enhance quality of life. Non-adherence to ART is however prevalent among HIV-positive people, leading to treatment failure characterised by immune suppression, unsuppressed viral load, limited treatment options and increased treatment costs.

This study explored the experiences of HIV patients with unsuppressed viral loads and their efforts to adhere to treatment regimens. Employing a qualitative research design with an exploratory and descriptive approach, guided by an interpretive paradigm, the research engaged 15 participants through face-to-face interviews using maximum variation sampling.

Participants revealed various challenges hindering medication adherence, including social factors like non-disclosure, denial of HIV status, reluctance to take medication in public and use of traditional remedies. Forgetfulness and travel commitments also disrupted adherence. Additionally, poor patient-healthcare provider relationships and negative attitudes from healthcare workers were reported to exacerbate non-adherence. Treatment-related factors such as side effects contributed to decreased adherence, impacting self-esteem and confidence, though participants did not entirely cease medication usage.