A Qualitative Exploration of a Digital Adherence Platform's Impact on Viral Load Suppression Among Postpartum Women on Antiretroviral Therapy in Ghana's Ashanti Region

Postpartum women living with HIV in sub-Saharan Africa are at increased risk of poor adherence to antiretroviral therapy (ART) and unsuppressed viral loads. While digital adherence technologies are being introduced, their specific influence and acceptability among this group in West Africa remain under-researched. This study qualitatively explored the perceived impact of a digital adherence platform on viral load suppression among postpartum women on ART in Ghana's Ashanti Region. It aimed to understand the women's experiences, the perceived benefits of the platform, and the barriers to its use. A qualitative descriptive study was undertaken. In-depth interviews and focus group discussions were conducted with a purposively selected sample of postpartum women living with HIV who had used the platform for a minimum of six months. Healthcare providers involved in platform delivery were also interviewed. Data were analysed using thematic analysis. Three primary themes were identified. First, the platform was perceived to improve adherence through medication reminders and supportive contact from providers. Second, a significant barrier was the fear of unintended HIV status disclosure, which limited engagement for some women. Third, a key facilitator was the integration of platform interactions with routine maternal and child health services. Many participants directly associated their consistent use of the platform with achieving a suppressed viral load. The digital adherence platform was viewed as a useful tool for supporting ART adherence postpartum. However, its effectiveness is contingent on addressing confidentiality concerns. Successful implementation requires approaches that mitigate stigma and are aligned with existing healthcare services. Programme implementers should incorporate strong privacy safeguards into digital health interventions. Healthcare provider training should include counselling on disclosure risks. Future platforms could integrate features for broader postpartum care to enhance acceptability and utility. HIV, antiretroviral therapy, adherence, digital health, postpartum period, qualitative research, Ghana, viral load suppression This study provides insights into the contextual factors influencing the use of a digital adherence platform among postpartum women living with HIV in Ghana, highlighting the critical balance between technological support and the preservation of confidentiality.