Abstract:

HIV/AIDS prevalence remains a major global public health and development challenge despite key interventions to curb its spread. Ghana, in particular, for a decade now, has experienced a persistent increase in the number of HIV new infections among adults, with the new infection rates varying across the administrative regions. The study examines socio-demographic, health, social, behavioural, and biomedical factors contributing to the spread of HIV among adults in Ghana and how these factors vary across administrative regions. A case-control study was carried on involving 362 respondents made of 181 HIV cases and controls, each from the Ahafo and Northern regions of Ghana. Structured questionnaires were administered. Socio-demographic characteristics of respondents, their health status, social behavioural, and biomedical factors that have potential influence on the spread of HIV was collected. A logistic regression model was used to estimate the degree to which each of the risk factors collected were associated with the spread of HIV in Ghana and across regions. Out of 21 risk factors identified, 13 accounted for the spread of HIV in the Ahafo region compared to only 6 in the Northern region. The study concludes that factors for HIV spread in Ghana are many but vary across administrative regions in the country. It, therefore, suggests the need to create job opportunities, have HIV awareness campaign programmes, regulate the sale of alcoholic and other related drugs, discourage sex trade, promote condom use throughout the country for those who cannot abstain, and tailored to regions.

References:

[1] UNAIDS. 2019 Global AIDS Update: Communities at the Centre; July 2019. UNAIDS. AIDS info website; accessed September 2019, available at: http://aidsinfo.unaids.org/. UNAIDS. Fact sheet; September 2019.

[2] Ghana AIDS Commission (2019). Status of the National HIV and AIDS Response Report. Accra: Ghana AIDS Commission. 212. https://www.ghanaids.gov.gh/.

[3] Ghana National AIDS Commission, Annual report, 2018, p.1-5, accessed September 2019, available at: https://ghanaids.gov.gh/mcadmin/Uploads/nationalHIVandAIDSPolicy.pdf.

[4] Ghana National AIDS Control Programme Annual Report, 2019 accessed December 2020, available at: https://ghanaids.gov.gh/mcadmin/Uploads/NACP%20Annual%20Report%2019_Final.pdf.

[5] Chan, M., Sidibe, M., Lake, A., 2007. Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector. April. Geneva, WHO/UNAIDS/UNICEF 201706. https://www.afro.who.int/sites/default/files/2017-06/Towards-universal-access-en_0.pdf.

[6] World Bank report, 2017. Annual Report 2017: worldbank.org/annual report. Accessed at: https://thedocs.worldbank.org/en/doc/908481507403754670-0330212017/original/AnnualReport2017WBG.pdf.

[7] Manyahi J., Jullu B. S., Abuya M. I., Juma J., Ndayongeje J., Kilama B., Sambu V., Nondi J., Rabiel B., Somi G., Matee M. I. (2015). Prevalence of HIV and syphilis infections among pregnant women attending antenatal clinics in Tanzania, 2011. BMC Public Health. 2015 May 22; 15:501. doi: 10.1186/s12889-015-1848-5.

[8] Ankomah, A., Ganle, J. K., Lartey, M. Y., Kwara, A., Nortey, P. A., Okyerefo, M. P. K., & Laar, A. K. (2016). ART access-related barriers faced by HIV-positive persons linked to care in southern Ghana: a mixed method study. BMC Infectious Diseases, 16(1), 738. Retrieved from https://doi.org/10.1186/s12879-016-2075-0.

[9] Audet C.M, Burlison J., Troy D Moon T. D., Sidat M., Vergara A.E., & Vermund S. H. (2010). Sociocultural and epidemiological aspects of HIV/AIDS in Mozambique. BMC International Health and Human Rights 2010, 10:15. Retrieved from http://www.biomedcentral.com/1472-698X/10/15.

[10] Park, L., S., Siraprapasiri, T., Peerapatanapokin, W., Manne, J., Niccolai, L., and Kunanusont, C. (2010). HIV transmission rates in Thailand: evidence of HIV prevention and transmission decline. Journal of Acquired Immune Deficiency Syndromes, 54(4): 430-436.

[11] Shelton, J., D., Halperin, D., T., Nantulya, V., Potts, M., Gayle, H., D., Holmes, K., K. (2004). Partner reduction is crucial for balanced ―ABC‖ approach to HIV prevention: Behaviour change programmes to prevent HIV have mainly promoted condom use or abstinence, while partner reduction remains the neglected component of ABC. BMJ, 328: 891-4.

[12] Stoneburner, R., L., and Low-Beer, D. (2004). Population-Level HIV Declines and Behavioral Risk Avoidance in Uganda. SCIENCE 304, 714.

[13] Jewkes, R., Dunkle, K., Koss, M., P., Levin, J., B., Nduna, M., Jama, N., and Sikweyiya (2006). Rape perpetration by young, rural South African men: Prevalence, patterns and risk factors. Social Science and Medicine, 63(11): 2949-2961.

[14] Lurie, M., Rosenthal, S., Williams, B. (2009). Concurrency driving the African HIV epidemics: where is the evidence? Lancet, 374:1420-1421.

[15] Sawer, L., and Stillwaggon, E. (2010). Concurrent sexual partnerships do not explain the HIV epidemics in Africa: a systematic review of the evidence. Journal of the International AIDS Society13:34.

[16] Agyemang, S., (2009). Addressing HIV/AIDS pandemic in the Ejura Sekyedumase District: a study of knowledge, attitudes and sexual behavior among unmarried 15–24-year-olds. KNUST Space. handle/123456789/609. http://dspace.knust.edu.gh/handle/123456789/609.

[17] Buor, D., (2000b). Help Break Taboos on Sexuality. Ghana News Agency. General News of Monday, 18 September. https://www.ghanaweb.com/GhanaHomePage/NewsArchive/Help-break-taboos-on-sexuality-Lecturer-11252.

[18] Odoi-Agyarko, K. (2004). Socio-cultural Factors and Determinants Affecting Sexual Behaviour Among the Youth in the Upper East Region of Ghana. Paper Presented at the National HIV/AIDS Research Conference (NHARCON) held at La Palm Royal Beach Hotel, Accra, Ghana, February 11-13.

[19] Auerbach, J. (2009). Transforming Social Structures and Environments to help in HIV Prevention. Health Affairs, 28 (6): 1655-1665.

[20] Choudhry, V., Ambresin, A-E., Nyakato, V. N., & Agardh, A. (2015). Transactional sex and HIV risks-evidence from a cross-sectional national survey among young people in Uganda. Global Health Action, 8, 1-11. Retrieved from https://doi.org/10.3402/gha.v8.27249.

[21] Ghanem A., Little S. J., Drumright L., Liu L., Morris S., and Garfein R. S. (2015) PMC High-Risk Behaviors Associated with Injection Drug Use Among Recently HIV-Infected Men Who Have Sex with Men in San Diego, CA doi: 10.1007/s10461-011-9970-6.

[22] Clínicas, H., Medicina, F. De, & Paulo, D. S. (2012). Prior history of sexually transmitted diseases in women living with AIDS in São Paulo, Brazil, 16(3), 226–231.

[23] Wilson C. N., and Sathiyasusuman A (2015). Associated Risk Factors of STIs and Multiple Sexual Relationships among Youths in Malawi. Plos One Journal. Retrieved from https://doi.org/10.1371/journal.pone.0134286.

[24] Omoria R., and Laith J. A (2017). Sexual network drivers of HIV and herpes simplex virus type 2 transmission. AIDS (London, England). May 2017 DOI:10.1097/QAD.0000000000001542.

[25] Pettifor, A., Rees, H., Kleinschmidt, I., Steffenson, A., MacPhail, C., Hlongwa-Madikizela
L., Vermaak K., Padian N. S. (2005). Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. PMID: 16135907 DOI: 10.1097/01. AIDS. 0000183129.16830.06.

[26] Rahmanian, S., Wewers, M. E., Koletar, S., Reynolds, N., Ferketich, A., & Diaz, P. (2011). Cigarette Smoking in the HIV-Infected Population. Proceedings of the American Thoracic Society, 8(3), 313–319. Retrieved from https://doi.org/10.1513/pats.201009-058WR.

[27] Ghana Health Service, 2019. Ghana National Sentinel Surveillance Report, 2019. Ghana Health Service. Accessed at https://ghanaids.gov.gh/mcadmin/Uploads/HSS%202019%20Report%2027-08-2020.pdf.

[28] Beauclair, R., Helleringer, S., Hens, N., & Delva, W. (2016). Age differences between sexual partners, behavioural and demographic correlates, and HIV infection on Likoma Island, Malawi. Scientific Reports, 6(1), 36121. https://doi.org/10.1038/srep36121.

[29] Fortson J.G. the gradient in sub-saharan Africa: Socioeconomic status and HIV/AIDS. Demography 45, 303 – 322 (2008). https://doi.org/10.1353/dem.0.0006.

[30] Kolawole, I. E., 2010. Awareness and Perceptions of HIV/AIDS Preventive Strategies among students of Universities of Zululand and Ado-Ekiti. Unizulu Institutional Repository, 10530(633), http://hdl.handle.net/10530/633.

[31] Achappa, B., Madi, D., Bhaskaran, U., Ramapuram, J. T., Rao, S., & Mahalingam, S. (2013). Adherence to antiretroviral therapy among people living with HIV. North American Journal of Medical Sciences, 5(3), 220–223. https://doi.org/10.4103/1947 2714.109196.