Background: Current increase in HIV prevalence among MSM in Greater Accra region of
Ghana is a public health concern. This increase translates to a higher number of MSM being put on
antiretroviral treatment. However, ART adherence amongst HIV positive MSM in Ghana is
unknown. Lack of knowledge in ART adherence among MSM could affect the implementation
of the 90-90-90 fast track targets. This study, therefore, sought to determine the level of ART
adherence and factors influencing adherence amongst MSM in the Greater Accra region of
Methods: This was a cross-sectional study that employed a quantitative method. The study
was conducted in four selected facilities in the Greater Accra region from the period of April 13th
to June 29th, 2018. Through the assistance of ART ‗case managers‘, 223 participants on ART
across the four selected facilities were recruited for self-administered questions and interviewed
on ART adherence. Structured questionnaires were administered and analysis of quantitative data
was done using Stata15. Confidence Interval was set at 95% and p-value <0.05 for statistical
significance. The Pearson‘s Chi-square was used to test association between factors and ART
adherence. Multiple logistics regression model was used to quantify the adjusted effects of the
various factors on ART adherence.
Results: A total of 233 HIV positive MSM with a median age 24 years participated in the study.
Just a third 87(39%, 95% CI: 32.57, 45.75) of participants adhered to ART. Criminalization of
homosexuality was positively associated with ART adherence (p<0.033). Fear of gender
discrimination limiting sexual orientation disclosure for a holistic ART service was also
significantly associated with ART adherence (p<0.021).
Conclusions: This study demonstrated that ART adherence amongst MSM in the Greater Accra
region was low. Fear of gender discrimination limiting sexual orientation disclosure for a holistic
ART service were found to be a factor associated with the low ART adherence. This can impede
strategies to achieve the 2nd and 3rd 90 of the UNAIDS 90-90-90 HIV treatment targets among
MSM. Also, criminalization of homosexuality as perceived to be associated with ART adherence
was unsupported, and the perceived ART service disparity between homosexuals and
heterosexuals was not associated with ART adherence.
We recommend that Intensive ART adherence education and counseling should be provided by
Ghana AIDS Commission and partnered Civil Society Organizations (CSOs) with HIV
programming for MSM. The Ghana AIDS Commission should promote rigorous CSOs
Advocacy and intervention on eliminating fear of gender discrimination associated with sexual
orientation disclosure and ART adherence.
Edu, F (2021). Factors Associated With Antiretroviral Therapy Adherence Amongst Men Who Have Sex With Men In Selected Facilities. Afribary.com: Retrieved May 10, 2021, from https://afribary.com/works/factors-associated-with-antiretroviral-therapy-adherence-amongst-men-who-have-sex-with-men-in-selected-facilities
Frontiers, Edu. "Factors Associated With Antiretroviral Therapy Adherence Amongst Men Who Have Sex With Men In Selected Facilities" Afribary.com. Afribary.com, 26 Apr. 2021, https://afribary.com/works/factors-associated-with-antiretroviral-therapy-adherence-amongst-men-who-have-sex-with-men-in-selected-facilities . Accessed 10 May. 2021.
Frontiers, Edu. "Factors Associated With Antiretroviral Therapy Adherence Amongst Men Who Have Sex With Men In Selected Facilities". Afribary.com, Afribary.com, 26 Apr. 2021. Web. 10 May. 2021. < https://afribary.com/works/factors-associated-with-antiretroviral-therapy-adherence-amongst-men-who-have-sex-with-men-in-selected-facilities >.
Frontiers, Edu. "Factors Associated With Antiretroviral Therapy Adherence Amongst Men Who Have Sex With Men In Selected Facilities" Afribary.com (2021). Accessed May 10, 2021. https://afribary.com/works/factors-associated-with-antiretroviral-therapy-adherence-amongst-men-who-have-sex-with-men-in-selected-facilities