© Kamla-Raj 2015 J Hum Ecol, 50(3): 237-243 (2015) Exploring Underpinnings Weighing Down the Phenomenon of Adherence to Anti-Retroviral Drugs (ARVs) among the People Living With HIV/AIDS (PLWHA) in South Africa and Botswana: A Literature Review Simon M. Kang’ethe 1 and Thanduxolo Nomngcoyiya 2 University of Fort Hare, P/B X1314, Alice, South Africa Telephone: 1 <+27406022420>, 2 <+27406022420>, Mobile: 2 <0787751095>, 2 <073 502 2025> E-mail: 1 <skangethe@ufh.ac.za>, 2 <201006645@ufh.ac.za, tnomngcoyiya@gmail.com> KEYWORDS Stigma. Sexual Libido. Traditional Concoctions. Bio Medics. Traditional Healers ABSTRACT It is critical that People Living with HIV/AIDS (PLWHA) in African countries hard- hit by the HIV/ AIDS pandemic such as Botswana and South Africa be the cornerstone of a successful HIV/AIDS campaign by taking responsibility and accountability of taking the ARVs according to the drug regimen. Anti-retrovirals (ARVs) are very expensive and drains national coffers immensely that translates to a heavy burden on the tax payers. The aim of this paper is, through a review of literature methodology, to debate and discuss a few underpinnings behind the PLWHA defaulting their drug regimen. The following environment promotes defaulting: poverty and its ramifications such as lack of food; excessive intake of alcohol; capacity of the ARVs to deform body structure; use of both biomedical concoctions and those of traditional healers in tandem; sexual libido emanating to the use of ARVs; and stigma associated with taking ARVs. The paper recommends: strong awareness to strengthen PLWHA ownership of the campaign; immense community support of the PLWHA and the campaign generally; and further research on how to reduce food appetite and sexual libido. Address for correspondence: S.M. Kang’ethe Professor University of Fort Hare, P/B X1314, Alice, South Africa Telephone: +27406022420 Cell: 0787751095 E-mail: skangethe@ufh.ac.za INTRODUCTION Indubitably, the effects of HIV/AIDS and their impacts on society pose horrendous and pinching effects. This is because this pandemic is still surrounded by ignorance, prejudice, dis- crimination and stigma (Kang’ethe 2010a; Kang’ethe and Xabendlini 2014; Treatment Ac- tion Campaign 2007; Barnett and Whiteside 2006). It is estimated that 40 million people are infected with HIV worldwide, and 20 million peo- ple have so far died since the beginning of the pandemic in 1981 (UNAIDS, WHO, UNICEF 2011). Regrettably, about 22 million of those liv- ing with the virus hail from Sub-Saharan Africa with countries such as Swaziland, Botswana and South Africa experiencing very high prevalenc- es. Painstakingly, South Africa has the highest number of HIV infections in the world (UNAID, WHO, UNICEF 2011). Statistically, 5.6 million people in South Africa are sero-positive (South African National AIDS Council (SANAC) 2011; Irwin and Fallows 2003). In her continuous struggle to fight against HIV/AIDS pandemic, South African government came up with South Africa’s HIV/AIDS battle plan which was announced by President Jacob Zuma on World Aids Day in 2011. This new Na- tional Strategic Plan for HIV sought to ensure that at least 80 percent of the people who were eligible for HIV treatment were open to access it (Kagee 2011). This opened the door for many people living with HIV/AIDS to benefitting from the miraculous and empowering effects of the ARVs (Kang’ethe 2012). However, this would only be a panacea if every “Dick and Harry” living with HIV/AIDS would oblige to follow the drug regimen as prescribed by the doctors or health practitioners dispensing and administer- ing the ARVs (TAC 2007). Optimistically, perhaps the aforementioned arrangement would have an effect of stemming down the ever-burgeoning death statistics due to HIV/AIDS in both urban and rural settings of the country. This would be a great relief espe- cially to the rural areas hardest hit by the epi- demic. For example, a study by UNAIDS (2007) revealed that among the approximately 33.2 mil-