Implementation of Human Immunodeficiency Virus (Hiv) Screening and Antiretroviral Therapy (Art) among Tuberculosis (Tb) Clients in Tema Metropolitan District, Greater Accra Region of Ghana

Abstract

Background: Tuberculosis (TB) is a chronic infection which mainly affects the lungs. Due to the current Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) pandemic, TB has become a leading cause of mortality and morbidity, being the most common fatal opportunistic disease among PLHIV although curable. Five years after the revised policy on execution of joint TB/HIV activities was rolled out in Ghana with a yearly target of 100% HIV testing and Antiretroviral Therapy (ART) coverage for TB clients co-infected with HIV, 84% of TB clients were tested for HIV and less than half of these individuals are on ART. Objective: This study explored the challenges in implementing HIV screening and ART among TB clients in Tema Metropolitan District in the Greater Accra Region of Ghana. Methods: Using in-depth interviews (IDIs), the study provided data on the perspectives of policy-makers and service providers on the dual TB/HIV programme implementation, the TB clients’ knowledge of HIV/AIDS, HIV screening and ART and their willingness to accept and adhere to treatment if co-infected which were analyzed thematically. Results: Among the findings were barriers hampering TB/HIV collaboration which were insufficient funding, human resource shortages, loss to follow-up and discrimination. In addition, male clients were more knowledgeable about HIV/AIDS, screening and ART. Some expressed their unwillingness to accept ART, which was hinged on beliefs and drug quantity. Conclusion: These barriers to screening and ART uptake reinforce the need for sustained gender equality in education, empowerment, health promotion activities and increased CSO/private sector involvement.