Barriers and Facilitators of Antiretroviral Therapy (Art) Adherence Among People Living with HIV A Study at Ho Teaching Hospital in The Volta Region, Ghana

Abstract

Background: Despite the scale-up of Antiretroviral Therapy (ART) in Ghana, sustaining optimal adherence remains a significant challenge. Poor adherence compromises treatment outcomes, increases the risk of drug resistance, and undermines the country’s progress toward the UNAIDS 95-95-95 targets. Exploring the barriers and facilitators of ART adherence is therefore crucial for designing effective interventions. General Aim: The study explored the barriers and facilitators to adherence to ART among people living with HIV at Ho Teaching Hospital, Ghana. Methodology: A phenomenological qualitative design was employed. Fifteen participants aged 18 years and above who had been on ART for at least six months were purposively sampled, based on the principle of thematic saturation. Data were collected through semi-structured, in-depth interviews, transcribed verbatim, and thematically analyzed using Braun and Clarke’s framework. Results: Four key themes emerged: (i) individual-level factors such as knowledge, beliefs, psychological responses, forgetfulness, and side effects; (ii) interpersonal influences including family and partner support, peer influence, and stigma within relationships; (iii) community factors such as stigma, discrimination, and religious interpretations; and (iv) institutional and healthcare-related conditions such as accessibility of services, patient–provider relationships, and confidentiality. Facilitators included strong family and religious support, improved physical health, and positive patient–provider interactions, while barriers included stigma, medication side effects, forgetfulness, and long-term treatment fatigue. Conclusion: ART adherence at Ho Teaching Hospital is shaped by complex, multilevel influences. Effective interventions must address not only individual behaviors but also the broader interpersonal, community, and institutional contexts. Strengthening psychosocial support systems, reducing stigma, and improving healthcare delivery are critical for enhancing adherence and advancing Ghana’s HIV response.