# Perceived satisfaction with HIV care and its impact on medication adherence and clinical outcomes: a cross-sectional study in Kumasi, Ghana

## TL;DR

This study in Ghana found that high satisfaction with HIV care is linked to better medication adherence, but not to physical frailty, highlighting the need to improve clinic logistics and reduce waiting times.

## Contribution

The study is the first to investigate the relationship between patient satisfaction and clinical outcomes among people living with HIV in the Ghanaian context.

## Key findings

- 84.1% of participants were satisfied with HIV care, with long waiting times and lack of logistics being the main causes of dissatisfaction.
- Dissatisfaction with care was independently associated with lower odds of high medication adherence.
- Satisfaction with care had no significant impact on frailty among participants.

## Abstract

HIV/AIDS continues to pose a significant public health challenge, affecting millions of people worldwide. In Ghana, HIV affects 1.5% of the population, totaling 330,000 individuals and resulting in more than 14,000 deaths annually. To date, HIV has no cure and remains a chronic infection, often requiring frequent hospital visits. Given the frequent hospital visits associated with HIV/AIDS, patient satisfaction with care plays a significant role in adherence and treatment outcomes. However, factors associated with satisfaction with care and its impact on clinical outcomes has barely been investigated in the Ghanaian setting. This study assessed the level of satisfaction with care and its association with adherence among people living with HIV (PLWH) in Kumasi, Ghana.

This cross-sectional study involved 315 PLWH attending the Komfo Anokye Teaching Hospital and Aniniwah Medical Center. A well-structured validated questionnaire was administered to obtain data on sociodemographic, clinical parameters, lifestyle, and satisfaction with care. The Tilburg Frailty Indicator and Adherence to Chronic Disease Scale were used to assess frailty syndrome and medication adherence. Viral load and other relevant medical records were also retrieved from the folders of participants. Statistical analysis was performed using SPSS version 26 and GraphPad Prism version 8.0. p < 0.05 was considered statistically significant.

The proportion of participants satisfied with care was 84.1%. Dissatisfaction with care was mainly due to the long waiting time (36.8%) and the lack of logistics (11.4%). The prevalence of high medication adherence, frailty, viral suppression and rebound were 38.7%, 38.4%, 75.5% and 6.6%, respectively. Dissatisfaction with care [aOR = 0.39, 95% CI (0.18–0.85), p = 0.017] was independently associated with lower odds of high medication adherence. However, no statistically significant association was observed between satisfaction and frailty.

The level of satisfaction was high among PLWH, with long waiting time and lack of logistics being the main causes of dissatisfaction with care. Satisfaction with care significantly influenced medication adherence, but had no impact on frailty among participants. This calls for measures to reduce patient long waiting time and upgrading logistics at various HIV treatment centers improve patients’ satisfaction and medication adherence.