Evaluating facilitators of electronic adherence device adoption for robust antiretroviral treatment among PWHIV

Poor antiretroviral therapy adherence undermines clinical outcomes and hinders progress toward the UNAIDS 95-95-95 targets. Electronic pillboxes (EPBs) represent a potentially transformative adherence-support tool, particularly in resource-limited African settings. This study applied Rogers’ Diffusion of Innovations (DOI) framework to explore factors influencing the willingness to adopt EPBs among people living with HIV (PWHIV) in Cameroon. To identify perceived drivers and barriers to EPB adoption among PWHIV in Cameroon using the DOI framework. In-depth, semi-structured interviews were conducted with 23 participants attending various clinics in Cameroon’s Centre Region. Guided by the DOI framework, the interviews explored participants’ baseline awareness of EPBs, openness to trial use, perceived benefits, and adoption concerns. Transcripts were thematically coded using constant comparison to identify key facilitators and barriers. Most participants were unfamiliar with EPBs. Many emphasized the need for hands-on trial use and demonstrable benefits prior to full adoption. Key barriers included fear of unintended HIV status disclosure, discomfort with unfamiliar technology, concerns over cost and availability, and infrastructural limitations. Psychosocial compatibility was especially influential. Gender-based differences emerged: men frequently sought efficacy data and trial experience, while women favored ease of integration into existing routines. While EPBs show clear adherence benefits, successful adoption requires addressing context-specific barriers such as stigma and access. Community education and gender-sensitive strategies, including data-driven engagement for men and integration support for women, may enhance uptake. Strengthening user familiarity may further improve psychosocial fit and promote adoption.