Factors Affecting Access to Care for Sexual Minorities Living with Human Immune Deficiency Virus at Ga-East Municipality.

Abstract

Background: Men who have sex with men (MSM), a key subgroup within the sexual minority population, experience a disproportionately high burden of HIV, often compounded by stigma, discrimination, and social exclusion. Such stigma is linked to shame and rejection that hinder healthcare-seeking behaviour and adherence to antiretroviral therapy (ART). Purpose: This study explored the factors influencing access to HIV care among sexual minorities living with HIV in Accra, Ghana, guided by Andersen’s Behavioural Model. Methods: A qualitative interpretive descriptive design was employed, involving in-depth interviews with 11 participants attending the International Health Care Centre (WAAF’s Clinic). Data were audio-recorded, transcribed verbatim, and analysed deductively using thematic content analysis. Ethical principles, including informed consent, voluntary participation, and confidentiality, were strictly observed. Results: Five major themes and 14 subthemes emerged: (1) individual experience in accessing HIV care and service (healthcare providers’ relationship, impact of anti-LGBTQ+ legislation, satisfaction with services); (2) healthcare access and support systems (financial support and medication accessibility, confidentiality concerns); (3) peer and family support of sexual minorities living with HIV (stigma, family dynamics, peer and community support, discrimination); (4) individual experiences of sexual minorities living with HIV (reaction to diagnosis, antiretroviral medicine, personal history); and (5) coping mechanisms and adaptive strategies (religious and spiritual coping, psychological adaptation to treatment). Conclusion: Stigma, discrimination, and limited policy awareness continue to hinder healthcare access for sexual minorities living with HIV, while resilience, peer support, and MSM-friendly facilities facilitate care. Addressing stigma and implementing inclusive policies are essential to improving ART adherence and advancing Ghana’s contribution to the UNAIDS 2030 goal of ending AIDS.