HIV/AIDS prevention and treatment interventions in Ghana: an assessment of the role of state and non-state actors

ABSTRACT The AIDS epidemic has become one of the most serious health and development challenges in the world today. In 2010, it was estimated that there were 225,478 persons living with HIV/AIDS in Ghana. An estimated 12,077 new infections and 15,263 AIDS deaths were also recorded during the same period. The HIV/AIDS sentinel surveillance indicated Agomanya and Koforidua had the highest site prevalence of 8.0% and 5.8% respectively while Wa had 2.0% with Tamale recording the lowest 1.2%. This thesis assessed state and non-state actors HIV/AIDS prevention and treatment interventions in Agomanya, Koforidua, Tamale and Wa. A sample of 299 respondents comprising 98 PLWHA, 40 FSWs, 48 pregnant women, 98 HIV/AIDS caregivers and 15 HIV focal persons were selected using mixed sampling techniques. Data were collected using questionnaires, structured interviews and focus group discussions. Content analysis, comparative analysis and direct quotations were employed as main tools to analyze the qualitative data whereas descriptive statistical analysis such as frequencies, percentage distributions, tables, bar graphs and pie charts were used to analyze quantitative data and present findings. Results showed that community sensitization, radio programmes, peer educators and drama groups were employed by state and non-state actors to create HIV/AIDS awareness, reduce stigma, encourage people to undergo Testing and Counselling and PMTCT and educate people on correct and consistent condom use. The effects of these interventions were that trend of HIV/AIDS prevalence in the communities was not steady but rather fluctuates. Knowledge of unprotected sextual intercourse with an infected person as modes of HIV transmission was 46.9 and 39.8% among PLWHA and Caregivers respectively in all the study communities. Male caregivers (65.6%) and PLWHA (68.8%) reported having sexual intercourse with multiple partners in the last twelve months in all the study communities. Condom use among male caregivers and male PLWHA with multiple partners in the last twelve months was 39.3% and 37.5% respectively. However, 71.9% of ii FSWs reported not using condom consistently with non-paying partners in all the study communities. The level of stigma was high with only 27.9% of male caregivers willing to inform their spouses if they tested positive for HIV in all the study communities. Only 53.1% and 40.9% of male and female PLWHA respectively have informed their spouses of their HIV positive sero-status. Stigma, condom promotion, funding and socio-cultural issues were some challenges identified. Finally state and non-state actors were working assiduously to provide interventions to combat HIV/AIDS. This notwithstanding, stakeholders have failed to tackle the issue of socio-cultural practices and integrate female sex workers, poverty reduction and women empowerment programmes into mainstream HIV/AIDS interventions. There is therefore the need for state and non-state actors to adopt an approach to HIV/AIDS prevention whereby behavioural and biomedical approaches are combined with structural approach for a successful battle against the epidemic.

Source: KNUST