Prevalence, Patterns, and Factors Associated With Adverse Drug Reactions Among People Living With HIV Receiving Antiretroviral Therapy at a Secondary Healthcare Facility in Ghana: A Retrospective Cross‐Sectional Study

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ABSTRACT Background and Aims Despite major progress in antiretroviral therapy (ART) scale‐up, adverse drug reactions (ADRs) remain a common challenge in HIV care and may compromise adherence, regimen continuity, and treatment outcomes. In Ghana, facility‐level evidence on the burden and characteristics of ART‐related ADRs remains limited. This study assessed the prevalence, patterns, and factors associated with ADRs among people living with HIV receiving ART at a secondary healthcare facility. Methods A retrospective cross‐sectional study was conducted using 355 patient records from January to December 2024 at St. Martin de Porres Hospital, Eikwe. Data on sociodemographic and clinical characteristics, ART regimen type, treatment duration, adherence documentation, and recorded ADRs were extracted using a structured data collection form. Descriptive statistics were used to summarize patient characteristics and ADR patterns. Associations between ADR occurrence and selected variables were assessed using chi‐square tests and Welch's t‐tests. Variables with p ≤ 0.20 were included in a multivariable logistic regression model to examine factors independently associated with ADRs. Statistical significance was set at p < 0.05. Results Overall, 43.9% of patients experienced at least one documented ADR. Gastrointestinal reactions were most frequent (32.1%), followed by neurological (21.2%) and skin reactions (16.7%). Most ADRs were mild (52.6%), while 16.0% were classified as severe. The majority of ADRs had resolved (62.2%); however, 12.2% resulted in treatment discontinuation. ART regimen type and treatment duration were significantly associated with ADR occurrence at the bivariate level. In multivariable analysis, use of second‐line (AOR: 1.84; 95% CI: 1.12–3.05) and third‐line regimens (AOR: 3.57; 95% CI: 1.33–10.70), undocumented adherence (AOR: 2.08; 95% CI: 1.10–4.00), and treatment duration under 6 months (AOR: 4.12; 95% CI: 1.35–12.54) were independently associated with ADRs. Conclusion ADRs remain a substantial concern in routine ART delivery at the facility level. The observed associations with regimen type, early treatment duration, and adherence documentation highlight key programmatic areas for strengthening pharmacovigilance and patient monitoring. Improving ADR documentation and adherence monitoring may support safer and more sustainable ART delivery in similar resource‐constrained settings.

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