Availability of HIV services along the continuum of HIV testing, care and treatment in Ghana

Stephen Ayisi Addo,Jinkou Zhao,Akosua N Baddoo,Alfred Yawson,Ivy Okae,Ekow Wiah,Nibretie Workneh,Marijanatu Abdulai

doi:10.1186/s12913-018-3485-z

Abstract

BackgroundGhana 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.MethodA 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.ResultsOf 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%).ConclusionThis 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.

Highlights

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
Routine HIV related service offered at different anti-retroviral therapy (ART) facilities Service providers were asked about HIV related services that were offered at their facilities
Services that were offered at different facilities ranged from HIV testing and counselling to viral load specimen collection and laboratory testing

Summary

Introduction

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. The continuum of HIV testing, care, and treatment covers a wide range of activities which aim at early detection of HIV cases through HIV testing services, care and support, anti-retroviral therapy (ART), adherence monitoring and. Limited or incomplete availability of services along the HIV testing- care - treatment continuum can negatively affect HIV. Where testing services are not available, this will undermine know your status campaign which is required to achieve the 90% of people knowing their HIV status by 2020 to achieve the end AIDS in 2030 target [3, 7]. Shortage of medications will undermine adherence and affect 90% treatment coverage required in the 90–90-90 global vision on HIV control [8]

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Discussion

Conclusion