Availability of HIV Services Along the Continuum of HIV Testing, Care and Treatment in Ghana

Overview

Journal BMC Health Serv Res

Publisher Biomed Central

Specialty Health Services

Date 2018 Sep 28

PMID 30257660

Citations 10

Authors

Stephen Ayisi Addo

Marijanatu Abdulai

Alfred Yawson

Akosua N Baddoo

Jinkou Zhao

Nibretie Workneh

Ivy Okae

Ekow Wiah

Affiliations

Soon will be listed here.

Abstract

Background: Ghana has been providing HIV and AIDS services since the identification of the first case in 1986 and added highly active antiretroviral therapy to its comprehensive care in 2003.This study aimed at assessing availability of HIV services along the continuum of HIV care in Ghana.

Method: A cross sectional study was conducted among 172 (87%) of the total 197 ART canters in Ghana. Data was collected by self-administered questionnaire and analysed using STATA version 13.

Results: Of the 172 health facilities surveyed, 165 (96%) were offering HIV testing Services (HTS) during the survey period. More than 90% of the surveyed facilities reported to offer Anti-Retroviral Treatment (ART), patient counselling, TB screening and Prevention of Mother to Child Transmission (PMTCT) services. Viral load and Early Infant Diagnosis (EID) and laboratory testing services were reported at 10 (5.8%) and 23 (13.4%) respectively. HIV testing services (HTS), PMTCT, ART, patient counselling and opportunistic infections (OI) prophylaxis services were offered at all Tertiary and Regional hospitals surveyed. EID sample collection and testing services was reported at 2 out of 27 (7.4%) of the Health Centre and/or clinics in Ghana. The common adherence assessment methodology being implemented varied by facilities which included: asking patients if they took their drugs 154 (89.5%), pill counting 131 (76.2%), use of follow-up visit 79(45.9%) and use of CD4 counts, viral loads and clinical manifestation 76 (44.2%). Challenges encountered by facilities included shortage of test reagents and drugs 122 (71%), 111 (65%) respectively and patient compliance 101 (59%).

Conclusion: This study showed ART services to be available in most facilities. Methods used to assess patients adherence varied across facilities. Shortage of test reagents and drugs, EID sample collection and testing were major challenges. A standardised approach to assessing patient's adherence is recommended. Measures should be put in place to ensure availability of HIV commodities at all levels.

Citing Articles

Replicative co-infections with human immunodeficiency virus 1 and 2 as well as hepatitis B and C virus in Ghanaian individuals.

Glyschewski L, Hahn A, Rohde H, Lutgehetmann M, Feldt T, Sarfo F Eur J Microbiol Immunol (Bp). 2024; 14(4):346-360.

PMID: 39475752 PMC: 11836648. DOI: 10.1556/1886.2024.00103.

Motivation, responsibilities, and experiences of HIV/AIDS counselors in the Volta Region of Ghana: a descriptive phenomenological study.

Dwomoh F, Douglas M, Charles-Unadike V, Komesuor J, Manu E AIDS Res Ther. 2024; 21(1):60.

PMID: 39217331 PMC: 11365179. DOI: 10.1186/s12981-024-00648-x.

Achieving the UNAIDS 95-95-95 treatment target by 2025 in Ghana: a myth or a reality?.

Boakye D, Adjorlolo S Glob Health Action. 2023; 16(1):2271708.

PMID: 37921654 PMC: 10627043. DOI: 10.1080/16549716.2023.2271708.

Evaluation of the pediatric antiretroviral therapy service in Gondar city public health facilities-A case study design with mixed methods.

Azanaw A, Alemu M, Yitayal M, Aschalew A PLoS One. 2022; 17(12):e0279890.

PMID: 36584222 PMC: 9803297. DOI: 10.1371/journal.pone.0279890.

Compliance to HIV testing and counseling guidelines at antenatal care clinics in the Kassena-Nankana districts of northern Ghana: A qualitative study.

Choi W, Sakeah E, Oduro A, Aburiya J, Aborigo R PLoS One. 2022; 17(9):e0274871.

PMID: 36178884 PMC: 9524674. DOI: 10.1371/journal.pone.0274871.

References

Hemelaar J . Implications of HIV diversity for the HIV-1 pandemic. J Infect. 2012; 66(5):391-400. DOI: 10.1016/j.jinf.2012.10.026. View

Roberts T, Cohn J, Bonner K, Hargreaves S . Scale-up of Routine Viral Load Testing in Resource-Poor Settings: Current and Future Implementation Challenges. Clin Infect Dis. 2016; 62(8):1043-8. PMC: 4803106. DOI: 10.1093/cid/ciw001. View

Sahay S, Reddy K, Dhayarkar S . Optimizing adherence to antiretroviral therapy. Indian J Med Res. 2012; 134(6):835-49. PMC: 3284093. DOI: 10.4103/0971-5916.92629. View

Giordano T, Guzman D, Clark R, Charlebois E, Bangsberg D . Measuring adherence to antiretroviral therapy in a diverse population using a visual analogue scale. HIV Clin Trials. 2004; 5(2):74-9. DOI: 10.1310/JFXH-G3X2-EYM6-D6UG. View

Timimi H, Falzon D, Glaziou P, Sismanidis C, Floyd K . WHO guidance on electronic systems to manage data for tuberculosis care and control. J Am Med Inform Assoc. 2012; 19(6):939-41. PMC: 3534454. DOI: 10.1136/amiajnl-2011-000755. View

Legido-Quigley H, Montgomery C, Khan P, Atun R, Fakoya A, Getahun H . Integrating tuberculosis and HIV services in low- and middle-income countries: a systematic review. Trop Med Int Health. 2012; 18(2):199-211. DOI: 10.1111/tmi.12029. View

Dora C, Haines A, Balbus J, Fletcher E, Adair-Rohani H, Alabaster G . Indicators linking health and sustainability in the post-2015 development agenda. Lancet. 2014; 385(9965):380-91. DOI: 10.1016/S0140-6736(14)60605-X. View

Mbuagbaw L, Sivaramalingam B, Navarro T, Hobson N, Keepanasseril A, Wilczynski N . Interventions for Enhancing Adherence to Antiretroviral Therapy (ART): A Systematic Review of High Quality Studies. AIDS Patient Care STDS. 2015; 29(5):248-66. PMC: 4410452. DOI: 10.1089/apc.2014.0308. View

Srikantiah P, Ghidinelli M, Bachani D, Chasombat S, Daoni E, Mustikawati D . Scale-up of national antiretroviral therapy programs: progress and challenges in the Asia Pacific region. AIDS. 2010; 24 Suppl 3:S62-71. DOI: 10.1097/01.aids.0000390091.45435.ea. View

10.

Marazzi M, Bartolo M, Emberti Gialloreti L, Germano P, Guidotti G, Liotta G . Improving adherence to highly active anti-retroviral therapy in Africa: the DREAM programme in Mozambique. Health Educ Res. 2005; 21(1):34-42. DOI: 10.1093/her/cyh039. View

11.

Wang H, He G, Li X, Yang A, Chen X, Fennie K . Self-Reported adherence to antiretroviral treatment among HIV-infected people in Central China. AIDS Patient Care STDS. 2007; 22(1):71-80. DOI: 10.1089/apc.2007.0047. View

12.

Ding H, Wilson C, Modjarrad K, McGwin Jr G, Tang J, Vermund S . Predictors of suboptimal virologic response to highly active antiretroviral therapy among human immunodeficiency virus-infected adolescents: analyses of the reaching for excellence in adolescent care and health (REACH) project. Arch Pediatr Adolesc Med. 2009; 163(12):1100-5. PMC: 3739292. DOI: 10.1001/archpediatrics.2009.204. View

13.

van Loggerenberg F, Grant A, Naidoo K, Murrman M, Gengiah S, Gengiah T . Individualised motivational counselling to enhance adherence to antiretroviral therapy is not superior to didactic counselling in South African patients: findings of the CAPRISA 058 randomised controlled trial. AIDS Behav. 2014; 19(1):145-56. PMC: 4185011. DOI: 10.1007/s10461-014-0763-6. View

14.

Gianotti N, Galli L, Bocchiola B, Cahua T, Panzini P, Zandona D . Number of daily pills, dosing schedule, self-reported adherence and health status in 2010: a large cross-sectional study of HIV-infected patients on antiretroviral therapy. HIV Med. 2012; 14(3):153-60. DOI: 10.1111/j.1468-1293.2012.01046.x. View

15.

Kaplan J, Hanson D, Dworkin M, Frederick T, Bertolli J, Lindegren M . Epidemiology of human immunodeficiency virus-associated opportunistic infections in the United States in the era of highly active antiretroviral therapy. Clin Infect Dis. 2000; 30 Suppl 1:S5-14. DOI: 10.1086/313843. View

16.

Sacktor N . The epidemiology of human immunodeficiency virus-associated neurological disease in the era of highly active antiretroviral therapy. J Neurovirol. 2002; 8 Suppl 2:115-21. DOI: 10.1080/13550280290101094. View

17.

Lawn S, Myer L, Orrell C, Bekker L, Wood R . Early mortality among adults accessing a community-based antiretroviral service in South Africa: implications for programme design. AIDS. 2005; 19(18):2141-8. DOI: 10.1097/01.aids.0000194802.89540.e1. View

18.

Hoenigl M, Chaillon A, Moore D, Morris S, Mehta S, Gianella S . Rapid HIV Viral Load Suppression in those Initiating Antiretroviral Therapy at First Visit after HIV Diagnosis. Sci Rep. 2016; 6:32947. PMC: 5011704. DOI: 10.1038/srep32947. View

19.

Cohen M, Chen Y, McCauley M, Gamble T, Hosseinipour M, Kumarasamy N . Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011; 365(6):493-505. PMC: 3200068. DOI: 10.1056/NEJMoa1105243. View

20.

Perera A, Thomas M, Moore J, Faasse K, Petrie K . Effect of a smartphone application incorporating personalized health-related imagery on adherence to antiretroviral therapy: a randomized clinical trial. AIDS Patient Care STDS. 2014; 28(11):579-86. PMC: 4216527. DOI: 10.1089/apc.2014.0156. View