Abstract:
Background Poor adherence and under-utilization of antiretroviral therapy (ART) services have been major setbacks
to achieving 95-95-95 policy goals in Sub-Saharan Africa. Social support and mental health challenges may serve
as barriers to accessing and adhering to ART but are under-studied in low-income countries. The purpose of this
study was to examine the association of interpersonal support and depression scores with adherence to ART among
persons living with HIV (PLWH) in the Volta region of Ghana.
Methods We conducted a cross-sectional survey among 181 PLWH 18 years or older who receive care at an ART
clinic between November 2021 and March 2022. The questionnaire included a 6-item simplified ART adherence
scale, the 20-item Center for Epidemiologic Studies Depression Scale (CES-D), and the 12-item Interpersonal Support
Evaluation List-12 (ISEL-12). We first used a chi-squared or Fisher’s exact test to assess the association between these
and additional demographic variables with ART adherence status. We then built a stepwise multivariable logistic
regression model to explain ART adherence.
Results ART adherence was 34%. The threshold for depression was met by 23% of participants, but it was not
significantly associated with adherence in multivariate analysis(p=0.25). High social support was reported by 48.1%,
and associated with adherence (p=0.033, aOR=3.45, 95% CI=1.09–5.88). Other factors associated with adherence
included in the multivariable model included not disclosing HIV status (p=0.044, aOR=2.17, 95% CI=1.03–4.54) and
not living in an urban area (p=0.00037, aOR=0.24, 95% CI=0.11–0.52).
Conclusion Interpersonal support, rural residence, and not disclosing HIV status were independent predictors of
adherence to ART in the study area.
