Closing the Gap in Ghana's HIV 95-95-95 Targets: Policy Levers to Improve Retention

Closing the Gap in Ghana’s HIV 95-95-95 Targets: Policy Levers to Improve Retention Abstract: This paper analyzes Ghana’s gaps in achieving the UNAIDS 95-95-95 targets and applies the Control Knobs Framework to identify organizational and behavioral policy levers to improve retention in antiretroviral therapy (ART) programs. Recommendations include decentralizing HIV services through CHPS compounds and strengthening psychosocial and stigma-reduction interventions. Keywords: HIV/AIDS, Ghana, retention, ART, Control Knobs Framework, health systems Closing the Gap in Ghana’s HIV 95-95-95 Targets: Policy Levers to Improve Retention Ghana has approximately 334,721 people living with HIV, yet only 68% know their status and 69% of those diagnosed are on ART. Retention remains a major barrier. Applying the Control Knobs Framework shows that organizational reforms such as integrating HIV care into CHPS compounds, would reduce travel burden and strengthen continuity. Behavioral reforms including stigma reduction, SMS reminders, and peer navigators can improve adherence and prevent loss to follow-up. Evidence from South Africa, Kenya, and Uganda shows decentralized care increases retention by 15–25%. Behavioral support increase adherence by 20–30%. Strengthening both levers is essential for Ghana to close the 95-95-95 gap. Conclusion: Ghana can accelerate progress toward 2030 HIV goals through organizational decentralization and behavior-focused adherence support.