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 women’s ability to maintain antiretroviral therapy. Addressing these challenges requires policies and interventions that integrate biomedical, social, and structural perspectives, while recognizing women’s autonomy and promoting equity in HIV care.