Social Contexts of Living with HIV/AIDS in the Eastern Region of Ghana

Abstract

The livelihoods of persons living with HIV/AIDS (PLWHAs) in Ghana and sub-Saharan Africa have generally been under-researched using the social context approach. Employing the social context explanatory framework, we explore the livelihoods and challenges facing 38 PLWHAs in the Lower Manya Krobo Municipality (LMKM) in the Eastern Region of Ghana. LMKM has the highest prevalence of HIV/AIDS in Ghana. In-depth interviews have been conducted with participants who are outpatients at either of the two HIV/AIDS clinics in the study area. Their family relations, healthcare, healthcare seeking, and health status have been explored. The findings show the participants to generally be poor, have poorer health, and to have had some challenges to healthcare seeking, including food insecurity. They also lack sufficient support from family and romantic partners. Most have family members and romantic partners who had succumbed to HIV/AIDS. The participants generally have a high burden of child dependents, including orphans from HIV/AIDS. Our explanatory model confirms that the participants are caught at the interphase of intrapersonal, interpersonal, community, and national vulnerabilities that are interdependent and reciprocal. Safety-net provisions such as the National Health Insurance scheme provide them with inadequate social protection. For improved health status and general livelihood, we recommend more pro-active social support for the participants and their dependents. Furthermore having stakeholders make greater efforts is recommended for strengthening Ghana's economy against shocks.

Immediate reactions of newly-diagnosed HIV-positive persons to the initial news of being HIV-positive: Implications for public health

“…A fair number of the respondents mentioned being infected by their spouses/partners who were alive or deceased [also see 69], implying that they probably were not using condoms and other modes to prevent HIV transmission from their sexual partners. This nding is not unlikely considering that Owusu [24] found that the PLWHAs studied were hardly using any form of protection against HIV with their sexual partners, whether in stable or unstable relationships. Two respondents were exceptions--they used condoms, but inconsistently [69].…”

“…Respondents participated in an informed consent process and provided written consent unless the respondent was not literate; in such cases, verbal consent was provided. We did not use any identi able markers for the respondents [see 20,23,24,69].…”

“…Prior research has also established the fact that some of the PLWHAs in the LMKM, particularly the females, have very little social resources at their disposal. These include inadequate social support, quite entrenched poverty, distressed housing, and often single-parenting to support their biological children as well as children of extended family [23,24]. In particular, it is well known that there is severe stigma, discrimination and abuse of PLWHAs in Ghana, including the LMKM [24,25,26], and sub-Saharan Africa (SSA) generally [27].…”

Immediate reactions of newly-diagnosed HIV-positive persons to the initial news of being HIV-positive: Implications for public health

“…One person declined to be interviewed, citing time constraints. No identi able markers were used for the respondents [see 20,43,51,55].…”

“…These included the choice of the title. Being fully aware of the extent of stigmatisation culturally associated with HIV/AIDS in Ghana [20,51,55], the PIs of the project from which data for this paper emanates were curious about how respondents would react on the spare of the moment they were diagnosed with the infection. Related contextual in uences on the author include how the PLWHAs would react given the resource-poor setting of the study area and the lower socio-economic status of women in Ghana, arguably more so in patriachical settings such as the LMKM.…”