Attaining the 90-90-90 Targets: Barriers and Facilitators to Retention in Care and Adherence to Antiretroviral Therapy in a Ghanaian Referral Hospital

Abstract

The surge in new cases of HIV infection has assumed significant global concern. The increase has resulted in high trends of patients on anti-retroviral treatment in hospitals, particularly in Sub-Sharan Africa including Ghana where more than 300,000 people are currently on ART. Even though targets, policies and efforts are being implemented to improve patients’ adherence and continuance stay in care, HIV incidence is increasing in Ghana, especially among youth. This problem has been partly blamed on dearth of scholarly works on the issue, thus impeding effort towards the 90-90-90 targets. In order to contribute to policy and scholarly literature, this study explored facilitators and barriers to adherence and retention to ART among HIV patients at the Greater Accra Regional Hospital. This study was important because it provides adherence and retention policy recommendations to support Government and Internationals organisations such as UNAIDS. Anderson Model of Healthcare Utilisation was used to underpin the study. Qualitative methods case study was employed. The results show that, non-disclosure of status, socio-cultural relations, perceived improved medical condition, free medication, culture and religious orientation and support from health facility facilitate adherence to ART and retention in care. The study also found Model of Hopes play significant role as counselors, educators and hope models that visit patients at home, talk to them and encourage them to adhere. This has led to an improvement in adherence to ART among clients. The study also found that, older women who are not working adhere to treatment more than both working and non-working men. The study also noticed that, there is a gradual re-orientation where patients are not resorting to religious prayers, and spiritual assistance at the expense of ART. Financial, economic, stigma and religious related issues are barriers to adherence and retention among HIV patients.