Vulnerability and non-adherence to treatment in cisgender women living with HIV/AIDS: A scoping review (2000-2024)

BACKGROUND: Cisgender women are disproportionately affected by HIV/AIDS due to structural gender inequalities and intersecting social determinants, which generate vulnerability contexts that act as barriers to treatment adherence. METHODS: A scoping review to map studies examining vulnerability contexts influencing antiretroviral treatment non-adherence and discontinuation among cisgender women living with HIV/AIDS. Searches were performed in PubMed, SciELO, Scopus, Web of Science, and gray literature. A total of 78 studies published between 2000 and 2024 were included. RESULTS: Findings were organized across three vulnerability dimensions individual, social, and programmatic. Stigma emerged as a transversal element permeating all levels. Barriers included mental health conditions, substance use, pregnancy and postpartum dynamics, socioeconomic inequalities, gender-based violence, and structural barriers in health systems. A conceptual model, grounded in the socio-ecological perspective and the vulnerability framework, is proposed to illustrate how these factors interact to affect adherence. CONCLUSION: Vulnerability contexts significantly shape womenƒ_Ts ability to maintain antiretroviral therapy. Addressing these challenges requires policies and interventions that integrate biomedical, social, and structural perspectives, while recognizing womenƒ_Ts autonomy and promoting equity in HIV care. TRIAL REGISTRATION: This scoping review was conducted according to a previously published protocol, registered at Open Science Framework (https://osf.io/2ah3x/). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13690-026-01852-z

• Epidemiology and Determinants of Health
  • Determinants of Health
• Determinants of Health
  • Food security
  • Education
  • Social support
  • Health services
  • Stigma/discrimination
  • Abuse
  • Other
• Population(s)
  • Women
  • General HIV+ population
• Prevention, Engagement and Care Cascade
  • Engagement and Care Cascade
• Engagement and Care Cascade
  • Linkage/engagement in care
  • Treatment
• Substance Use
  • Alcohol
  • Nonmedicinal drugs
• Mental Health
  • Depression
  • Psychiatric disorders
• Health Systems
  • Governance arrangements