"One Pastor Advised Him to Stop Taking HIV Medication": Promoters and Barriers to HIV Care Among Gay, Bisexual, and Men Who Have Sex with Men Living with HIV in Ghana

Overview

Journal Res Sq

Date 2024 Apr 2

PMID 38562846

Authors

Gamji Rabiu Abu-Baare

Gloria Aidoo-Frimpong

Prince Amu-Adu

Edem Yaw Zigah

Melissa Stockton

Samuel Amuah

Richard Panix Amoh-Otoo

Laura Nyblade

Kwasi Torpey

LaRon E Nelson

Affiliations

Soon will be listed here.

Abstract

Introduction: Few studies examine Ghanaian gay, bisexual, and other men who have sex with men (GBMSM) experience with HIV diagnoses and linkage to care. This article provides qualitative accounts of promoters and barriers to care among GBMSM living with HIV in Ghana.

Methods: We recruited and interviewed 10 GBMSM living with HIV in two Ghanaian cities. We transcribed the interviews, coded the data, and used thematic content analysis.

Results: We found that community and healthcare facility (HCF) level HIV and sexual stigma, confidentiality issues, alternative medicine, and substance use remain the key barriers to care. Other barriers include healthcare system issues such as long wait times and economic problems (e.g., health insurance and financial difficulties). Nonetheless, HCF-level factors such as positive experiences with providers, HIV counseling, and detailed medication information facilitate adherence to care among GBMSM.

Conclusion: This study highlights the need for interventions that address linkage to care issues, especially substance use, disinformation, and misinformation among GBMSM and other Ghanaian communities.

Citing Articles

Qualitative description of interpersonal HIV stigma and motivations for HIV testing among gays, bisexuals, and men who have sex with men in Ghana's slums-BSGH-005.

Abu-Baare G, Shamrock O, Zigah E, Ogunbajo A, Dakpui H, Agbemedu G PLoS One. 2024; 19(6):e0289905.

PMID: 38837972 PMC: 11152275. DOI: 10.1371/journal.pone.0289905.

References

Mills E, Cooper C, Kanfer I . Traditional African medicine in the treatment of HIV. Lancet Infect Dis. 2005; 5(8):465-7. DOI: 10.1016/S1473-3099(05)70172-9. View

Abubakari G, Owusu-Dampare F, Ogunbajo A, Gyasi J, Adu M, Appiah P . HIV Education, Empathy, and Empowerment (HIVE): A Peer Support Intervention for Reducing Intersectional Stigma as a Barrier to HIV Testing among Men Who Have Sex with Men in Ghana. Int J Environ Res Public Health. 2021; 18(24). PMC: 8702001. DOI: 10.3390/ijerph182413103. View

Laar A, DeBruin D . Key populations and human rights in the context of HIV services rendition in Ghana. BMC Int Health Hum Rights. 2017; 17(1):20. PMC: 5541754. DOI: 10.1186/s12914-017-0129-z. View

Nosyk B, Montaner J, Colley G, Lima V, Chan K, Heath K . The cascade of HIV care in British Columbia, Canada, 1996-2011: a population-based retrospective cohort study. Lancet Infect Dis. 2013; 14(1):40-49. PMC: 4017913. DOI: 10.1016/S1473-3099(13)70254-8. View

Zigah E, Abu-Baare G, Shamrock O, Dakpui H, Apreku A, Boyd D . "For my safety and wellbeing, I always travel to seek health care in a distant facility"-the role of place and stigma in HIV testing decisions among GBMSM - BSGH 002. Health Place. 2023; 83:103076. DOI: 10.1016/j.healthplace.2023.103076. View

Lamorde M, Tabuti J, Obua C, Kukunda-Byobona C, Lanyero H, Byakika-Kibwika P . Medicinal plants used by traditional medicine practitioners for the treatment of HIV/AIDS and related conditions in Uganda. J Ethnopharmacol. 2010; 130(1):43-53. DOI: 10.1016/j.jep.2010.04.004. View

Nelson L, Nyblade L, Torpey K, Logie C, Qian H, Manu A . Multi-level intersectional stigma reduction intervention to increase HIV testing among men who have sex with men in Ghana: Protocol for a cluster randomized controlled trial. PLoS One. 2021; 16(11):e0259324. PMC: 8629287. DOI: 10.1371/journal.pone.0259324. View

Shamrock O, Abu-Baare G, Zigah E, Dakpui H, Adjaka G, LeBlanc N . Community stigma, victimization, and coping strategies among gay, bisexual, and other cis-gender men who have sex with men in slum communities in Ghana. BSGH-003. BMC Public Health. 2024; 24(1):966. PMC: 10998418. DOI: 10.1186/s12889-024-18242-1. View

Nyblade L, Mbuya-Brown R, Ezekiel M, Addo N, Sabasaba A, Atuahene K . A total facility approach to reducing HIV stigma in health facilities: implementation process and lessons learned. AIDS. 2020; 34 Suppl 1:S93-S102. DOI: 10.1097/QAD.0000000000002585. View

10.

Lawn S, Harries A, Anglaret X, Myer L, Wood R . Early mortality among adults accessing antiretroviral treatment programmes in sub-Saharan Africa. AIDS. 2008; 22(15):1897-908. PMC: 3816249. DOI: 10.1097/QAD.0b013e32830007cd. View

11.

Babel R, Wang P, Alessi E, Raymond H, Wei C . Stigma, HIV Risk, and Access to HIV Prevention and Treatment Services Among Men Who have Sex with Men (MSM) in the United States: A Scoping Review. AIDS Behav. 2021; 25(11):3574-3604. PMC: 8053369. DOI: 10.1007/s10461-021-03262-4. View

12.

Dako-Gyeke P, Snow R, Yawson A . Who is utilizing anti-retroviral therapy in Ghana: an analysis of ART service utilization. Int J Equity Health. 2012; 11:62. PMC: 3475040. DOI: 10.1186/1475-9276-11-62. View

13.

Mill J . I'm not a "basabasa" woman: an explanatory model of HIV illness in Ghanaian women. Clin Nurs Res. 2002; 10(3):254-74. DOI: 10.1177/c10n3r4. View

14.

Groves A, Stankard P, Bowler S, Jamil M, Gebrekristos L, Smith P . A systematic review and meta-analysis of the evidence for community-based HIV testing on men's engagement in the HIV care cascade. Int J STD AIDS. 2022; 33(13):1090-1105. PMC: 9660288. DOI: 10.1177/09564624221111277. View

15.

Ampofo W . Current Status of HIV/AIDS Treatment, Care and Support Services in Ghana. Ghana Med J. 2011; 43(4):142-3. PMC: 2956368. View

16.

Odeny T, Penner J, Lewis-Kulzer J, Leslie H, Shade S, Adero W . Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural Kenya. AIDS Res Treat. 2013; 2013:485715. PMC: 3664481. DOI: 10.1155/2013/485715. View

17.

Rosen S, Fox M . Retention in HIV care between testing and treatment in sub-Saharan Africa: a systematic review. PLoS Med. 2011; 8(7):e1001056. PMC: 3139665. DOI: 10.1371/journal.pmed.1001056. View

18.

Saalim K, Amu-Adu P, Amoh-Otu R, Akrong R, Abu-Baare G, Stockton M . Multi-level manifestations of sexual stigma among men with same-gender sexual experience in Ghana. BMC Public Health. 2023; 23(1):166. PMC: 9872747. DOI: 10.1186/s12889-023-15087-y. View

19.

Abu-Baare G, Shamrock O, Zigah E, Ogunbajo A, Dakpui H, Agbemedu G . Qualitative description of interpersonal HIV stigma and motivations for HIV testing among gays, bisexuals, and men who have sex with men in Ghana's slums-BSGH-005. PLoS One. 2024; 19(6):e0289905. PMC: 11152275. DOI: 10.1371/journal.pone.0289905. View

20.

Boyd D, Abubakari G, Turner D, Ramos S, Hill M, Nelson L . The Influence of Family Bonding, Support, Engagement in Healthcare, on PrEP Stigma among Young Black and Latino Men Who Have Sex with Men: A Path Analysis. Children (Basel). 2022; 9(3). PMC: 8947403. DOI: 10.3390/children9030330. View