Abstract
BackgroundIn 2014, the Joint United Nations Program on HIV/AIDS (UNAIDS) set out a treatment target with the objective to help end the AIDS epidemic by 2030. This was supported by the UNAIDS ’90-90-90’ target that by 2020, 90% of all people living with HIV (PLHIV) will know their HIV status; 90% of all those diagnosed with HIV will be on sustained antiretroviral therapy; and 90% of all people receiving antiretroviral therapy will have viral suppression. The concept of offering differentiated care services using community-based models is evidence-based and is suggested as a means to bring this target into reality. This study sought to explore the possible predictors and acceptability of Community-based health service provision among PLHIV accessing ART services at the Cape Coast Teaching Hospital (CCTH) in Ghana.MethodsA qualitative study, using 5 focus group discussions (FGD) of 8 participants per group, was conducted at the HIV Clinic in CCTH, in the Central Region of Ghana. Facilitators administered open-ended topic-guided questions. Answers were audio recorded, later transcribed and combined with notes taken during the discussions. Themes around Facility-based and Community-based service delivery and sub-themes developed from the codes, were verified and analyzed by the authors, with the group as the unit for analysis.ResultsParticipants expressed preference for facility–based service provision with the construct that, it ensures comprehensive health checks before provision of necessary medications. PLHIV in this study wished that the facility-based visits be more streamlined so “stable clients” could visit twice in a year to reduce the associated time and financial cost. The main barrier to community-based service delivery was concerns about stigmatization and abandonment in the community upon inadvertent disclosure of status.ConclusionsAlthough existing evidence suggests that facility-based care was relatively more expensive and time consuming, PLHIV preferred facility-based individualized differentiated model to a community-based model. The fear of stigma and discrimination was very strong and is the main barrier to community-based model among PLHIV in this study and this needs to be explored further and managed.
Highlights
In 2014, the Joint United Nations Program on Human immunodeficiency virus (HIV)/Acquired immunodeficiency syndrome (AIDS) (UNAIDS) set out a treatment target with the objective to help end the AIDS epidemic by 2030
In Ghana, there were an estimated 313,063 of people living with HIV (PLHIV) at the end of 2017 with 125,667 on antiretroviral therapy (ART) [1]
In 2014, the Joint United Nations Program on HIV/AIDS (UNAIDS) set out an aspiring treatment target with the objective to help end the AIDS epidemic by 2030. This ambitious target was given the needed impetus by the UNAIDS ’90-90-90’ target which was to the effect that by 2020, 90% of all people living with HIV will know their HIV status; 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; 90% of all people receiving antiretroviral therapy will have viral suppression
Summary
In 2014, the Joint United Nations Program on HIV/AIDS (UNAIDS) set out a treatment target with the objective to help end the AIDS epidemic by 2030 This was supported by the UNAIDS ’90-90-90’ target that by 2020, 90% of all people living with HIV (PLHIV) will know their HIV status; 90% of all those diagnosed with HIV will be on sustained antiretroviral therapy; and 90% of all people receiving antiretroviral therapy will have viral suppression. In 2014, the Joint United Nations Program on HIV/AIDS (UNAIDS) set out an aspiring treatment target with the objective to help end the AIDS epidemic by 2030 This ambitious target was given the needed impetus by the UNAIDS ’90-90-90’ target which was to the effect that by 2020, 90% of all people living with HIV will know their HIV status; 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; 90% of all people receiving antiretroviral therapy will have viral suppression. A lot of work is going into HIV testing and diagnosis, and making therapy easy and accessible for clients
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