AIDS and Behavior

, Volume 23, Issue 2, pp 433–444 | Cite as

Low Birthweight, Retention in HIV Care, and Adherence to ART Among Postpartum Women Living with HIV in Ghana

  • Kwame S. SakyiEmail author
  • Margaret Y. Lartey
  • Julie A. Dension
  • Caitlin E. Kennedy
  • Luke C. Mullany
  • Prince G. Owusu
  • Awewura Kwara
  • Pamela J. Surkan
Original Paper


Care for low birthweight (LBW) infants can contribute to psychological difficulties and stigma among mothers living with HIV, creating challenges for antiretroviral therapy (ART) adherence and retention in HIV care. We explored how caring for LBW infants affects maternal ART adherence and retention in care. We conducted 30 in-depth interviews with postpartum women living with HIV in Accra, Ghana: 15 with LBW infants and 15 with normal birthweight (NBW) infants. Compared to mothers with NBW infants, mothers with LBW infants described how caring for their newborns led to increased caregiver burden, prolonged hospital stays, and stigma—contributing to incomplete ART adherence and missed clinical appointments. For a few women, care for LBW infants created opportunities for re-engagement in HIV care and motivation to adhere to ART. Results suggest women living with HIV and LBW babies in Ghana face increased challenges that impact their adherence to care and ART.


Low birthweight Retention in HIV care ART adherence Postpartum women Qualitative 



The authors wish to thank Angela Yalley, Nathaniel Coleman, and Theresa Kusi for supporting data collection and Drs. Emily Hurley and Philip McNab for their comments on an earlier draft of the manuscript.


This study was funded by the 1) National Institutes of Health (Grant Numbers R25MH83620, T32DA1391); 2) the Johns Hopkins Center for Global Health; and 3) the Center for Qualitative Studies in Health and Medicine, Johns Hopkins University.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures preformed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obstained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Social and Behavioral Interventions Program, Department of International HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  2. 2.Center for Learning and Childhood Development GhanaAccraGhana
  3. 3.Department of Public and Environmental Wellness, School of Health SciencesOakland UniversityRochesterUSA
  4. 4.Department of Medicine & TherapeuticsUniversity of Ghana School of Medicine & Dentistry, CHSAccraGhana
  5. 5.Department of International Health, Global Epidemiology and Disease ControlJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  6. 6.Division of Infectious Disease and Global Medicine, Department of MedicineUniversity of FloridaGainesvilleUSA

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