Improving ARV adherence to reducing mortality among people living with HIV AIDS (PLWH) in the bolgatanga municipality of northern Ghana

Background: The advent of affordable and accessible antiretroviral (ARV) therapy HIV patients has led to the implementation of many ARV programs in many countries. This has necessitated the need to assess adherence level among ARV-users, in order to make recommendations to inform policy. Objective: To assess the challenges and opportunities for ARV adherence among ARV-users in Bolgatanga Regional Hospital of Ghana. Methods: A cross sectional survey involving clients on ART, Health providers and Non-Governmental Organisations (NGOs). Purposive systematic sampling was used selected 20 ARV-users, 9 different categories of service providers, and 2 international NGOs providing care and support to PLWH. Data was collected through administered questionnaire, observation and review of existing documents to ascertain ARV adherence in 2010. Results: Adherence level among ARV-users in Bolgatanga hospital was 90%; provider assessment through pill counts and appointments showed 95% adherence. Challenges to ARV adherence was the cost of ARVs, long distance to facility; waiting time, stigmatization, and seasonal food shortage. For instance 60% of respondents could not afford to pay for one month supply of ARVs, 65% and 85% had long distance and waiting time respectively as barriers. Mortality among PWLH on ARVs reduced from 9% in 2009 to 5% in 2010. The study revealed that NGOs provided vital roles in psychosocial support and bridged gaps between institutional based care and community based care that spur continuum of care for ARV adherence. Conclusions: Continuous monitoring of services to PLWH, identifying and implementing needed changes; would improve adherence and reduce mortality among PLWH