Promoters and inhibitors of treatment adherence among HIV/AIDS patients receiving antiretroviral therapy in Ghana: Narratives from an underserved population

Abstract

Adherence to antiretroviral therapy (ART) is essential to achieving an improved cluster of differentiation-4 (CD4) count, viral load, and quality of life while preventing drug resistance. Medication adherence among people living with Human Immunodeficiency Virus (HIV) is influenced by different factors. Several studies have identified adherence promoters and inhibitors that emanate from the internal and external environment. We conducted six (6) individual in-depth interviews and three (3) focus group discussions to explore adherence behaviour among patients diagnosed with HIV in a teaching hospital in Accra, Ghana. Participants were drawn from the intervention arm of a mobile phone adherence intervention program. They had been enrolled in the study for at least six (6) months before the interviews are conducted. Results revealed that participants adhered to treatment irrespective of prompts from significant others. Adherence promoters included perception of ART as part of daily routines, benefits of the ART, awareness of regimen, access to food, and transparency. Adherence inhibitors were forgetfulness, secrecy, waiting time, religious beliefs, and sleep. People living with HIV (PLWHIV) have the personal motivation to take medication; however, negative perceptions about HIV must be addressed to ensure optimum adherence behaviour.

Barriers and Enablers for Adherence to Antiretroviral Therapy Among People Living With HIV/AIDS in the Era of COVID-19: A Qualitative Study From Pakistan

“…It is important to note that religious fundamentalism is a very complex issue and often affects patients' preferences for antiretroviral therapy in our study and this factor was also reported by studies conducted in Zimbabwe (Mutambara et al, 2021), Nigeria (Victor-Aigbodion, 2020), Ghana (Dzansi et al, 2020), Iran (Aghaei et al, 2020) and United States (Vigliotti et al, 2020;Doolittle et al, 2021). In Ramadan, Muslims observe fasting during the daytime from sunrise to sunset.…”

Impact of antiretroviral therapy regimens adherence on perceived health and wellbeing status among adults living with HIV in Ghana

“…This finding is inconsistent with findings in Ghana where gender, fear of stigma, shortage of antiretroviral drugs, and financial difficulties were reported to predict ART adherence (Anokye-Kumatia et al, 2018;Nichols et al, 2019;Poku et al, 2020). Other promoters of ART adherence reported in a teaching hospital in Accra, Ghana; included perception of benefits of ART, awareness of ART regimen, access to food, and transparency on the part of clinicians (Dzansi et al, 2020), which we did not find in this study. The finding is also inconsistent with findings of fear of HIV stigma, gender, and non-disclosure of HIV status, and lower SES (Corless et al, 2017;Kim et al, 2018;Madiba & Josiah, 2019;Yu et al, 2018).…”

Perceived satisfaction with HIV care and its association with adherence to antiretroviral therapy and viral suppression in the African Cohort Study

“…Among participants dissatisfied with care, waiting time was given as the top reason. Waiting time was also reported by ART users at some ART facilities in Botswana, Ghana, Tanzania and Uganda as one of the main obstacles to optimal adherence [ 3 , 19 – 21 ]. A study conducted among 408 PLWH in Nigeria indicates that participants are satisfied with care in general but not waiting time (73%) [ 22 ].…”