Micro Level Construction of HIV/AIDS Disease Causality, Retribution and Changes in Living Arrangement with People Living With HIV/AIDS in a Rural Setting in Ghana: A Qualitative Study

Background Community perception, illness definition and meaning attribution to the causes and justification for the consequence of HIV acquisition on People Living With HIV/AIDS (PLWH) cumulatively affect their health-seeking behaviours, stigmatisation, quality of life and survival. The study examines rural Ghanaian dwellers construction of why and how people contract HIV/AIDS and their perception and attitudes towards PLWH. Methods Qualitative case study design and approach with purposive and snowballing sampling techniques facilitated the selection of 15 adult participants comprising two PLWH and other key informants from a rural Ghanaian community. A semi-structured interview guide aided in the collection of data from the participants. Data collected were analysed using NVivo 8 and presented using comparative emerging themes. Findings Participants from the community demonstrated varying perceptions and attitudes towards PLWH. Contraction of HIV/AIDS by a person was construed by community members to result from a person's lived unrestricted sexual lifestyle, accidental acquisition, predestination to contract the virus and punishment from ancestors. Others perceived PLWH as just normal beings with a foreign virus. Community-level causal explanations on why people acquired HIV were shaped by community members’ educational attainment, religious doctrines and inherent tenets, fear of the virus, regard for professional ethics and perceptions on PLWH gift reception. Conclusions Public education and awareness creation interventions should be re-intensified and delivered beyond urban and peri-urban centres to reach core PLWH and their community members within rural communities. Sustained micro-level education on HIV/AIDS awareness with feedback input is critical to stigma reduction.