Survival trends among people living with human immunodeficiency virus on antiretroviral treatment in two rural districts in Ghana

Abstract

Background The human immunodeficiency virus (HIV) has caused a lot of havoc since the early 1970s, affecting 37.6 million people worldwide. The 90-90-90 treatment policy was adopted in Ghana in 2015 with the overall aim to end new infections by 2030, and to improve the life expectancy of HIV seropositive individuals. With the scale-up of Highly Active Antiretroviral Therapy, the lifespan of People Living with HIV (PLWH) on antiretrovirals (ARVs) is expected to improve. In rural districts in Ghana, little is known about the survival probabilities of PLWH on ARVs. Hence, this study was conducted to estimate the survival trends of PLWH on ARVs. Methods A retrospective evaluation of data gathered across ARV centres within Tatale and Zabzugu districts in Ghana from 2016 to 2020 among PLWH on ARVs. A total of 261 participants were recruited for the study. The data was analyzed using STATA software version 16.0. Lifetable analysis and Kaplan-Meier graph were used to assess the survival probabilities. “Stptime” per 1000 person-years and the competing risk regression were used to evaluate mortality rates and risk. Results The cumulative survival probability was 0.8847 (95% CI: 0.8334–0.9209). The overall mortality rate was 51.89 (95% CI: 36.89–72.97) per 1000 person-years. WHO stage III and IV [AHR: 4.25 (95%CI: 1.6–9.71) p = 0.001] as well as age group (50+ years) [AHR: 5.02 (95% CI: 1.78–14.13) p = 0.002] were associated with mortality. Conclusion Survival probabilities were high among the population of PLWH in Tatale and Zabzugu with declining mortality rates. Clinicians should provide critical attention and care to patients at HIV WHO stages III and IV and intensify HIV screening at all entry points since early diagnosis is associated with high survival probabilities.