Is it Time to Start Delivering HIV Treatment Online?

Ghana must rethink how people living with HIV access their medication as stigma, fear of exposure and difficulties accessing healthcare threaten treatment adherence. Could online delivery and community pharmacies offer a solution?

For many people living with HIV in Ghana, the biggest challenge is not necessarily the availability of medication. It is finding the courage to walk into a health facility, collect the medication and return home without having their HIV status exposed to people around them.

In a society where HIV infection is still surrounded by stigma, discrimination and misconceptions, a visit to a health facility for antiretroviral treatment (ART) can become an emotionally difficult experience. Some patients fear being recognised by neighbours, friends, colleagues or relatives. Others worry that someone might see them at an HIV treatment centre and draw conclusions about their health status. For some, the fear of being discovered is so overwhelming that they would rather stop attending appointments than risk being identified.

Unfortunately, the consequences of such decisions can be devastating, not only for the individuals concerned but also for their sexual partners and the wider public. This raises an important question: Is it time for Ghana to rethink its approach to delivering HIV treatment and make antiretroviral medication more accessible through online platforms and community pharmacies?

The question deserves serious consideration, particularly as the country continues to confront the challenges of new HIV infections, treatment adherence and persistent stigma.

Although concerns about rising HIV infections deserve attention, the available national statistics suggest that Ghana’s situation is more complicated than a simple increase in infections.

According to the Ghana AIDS Commission’s 2025 National HIV Estimates and Projections, Ghana recorded an estimated 13,951 new HIV infections in 2025, down from 16,189 in 2024. AIDS-related deaths also declined from 13,429 to 12,051 over the same period.

However, approximately 337,435 people were living with HIV in Ghana in 2025. The figures suggest that the country is making progress, but the number of people who need sustained access to treatment remains substantial.

The situation in the Ashanti Region is also worth examining. The 2025 estimates put the number of new infections in the region at approximately 2,800, down from nearly 3,000 in the previous year. The region’s HIV prevalence remained at 1.59 per cent.

Speaking at a stakeholder engagement in Kumasi in September 2026, the Ashanti Regional Technical Coordinator of the Ghana AIDS Commission, Olivia Graham, identified stigma as one of the major obstacles to the country’s HIV response. She called for greater public education and support for people living with HIV to seek treatment. Ghana News Agency

These figures do not suggest that the country can afford to relax its efforts. Rather, they highlight the need to sustain progress by ensuring that people who test positive are not only enrolled in treatment but also remain on medication.

The issue of stigma deserves particular attention because HIV treatment is not simply about making medication available. It is also about creating an environment in which people feel comfortable accessing it.

Last week, on Auntie Naa’s Oyerepa Afutuo programme, two different women appeared with disturbing accounts of how they had contracted HIV from partners who knew they were living with the virus but had stopped attending treatment. Their accounts, as presented on the programme, raise difficult questions about treatment adherence, personal responsibility and the protection of sexual partners.

Why would someone who knows their HIV status abandon treatment? What happens when such a person continues engaging in sexual relationships without taking the necessary precautions? And could some of these situations be prevented if accessing medication did not come with the fear of being identified?

It is important not to assume that everyone who interrupts treatment does so because of stigma. Financial difficulties, transport costs, medication side effects, misinformation, denial and other personal circumstances can also contribute to treatment interruptions.

Nevertheless, stigma is a recognised barrier. In November 2025, the Ghana AIDS Commission identified denial and stigmatisation as significant reasons for low ART uptake in the country. At the time, the Commission reported that only 47.5 per cent of the estimated 334,721 people living with HIV in Ghana were receiving treatment, based on the 2024 estimates.

The implications are serious. People who discontinue ART risk experiencing a deterioration in their health, developing drug resistance in some circumstances and losing the protection that effective treatment provides against sexual transmission. This is why treatment accessibility must be considered an important part of HIV prevention.

One practical proposal is to expand access to antiretroviral medication through accredited community pharmacies. Pharmacies are among the most accessible healthcare points in Ghana. They are located in neighbourhoods, shopping centres and commercial areas, and many operate beyond the normal working hours of public health facilities.

A person can walk into a pharmacy to purchase medication for malaria, a headache or another common condition without attracting much attention. The same convenience could make a significant difference for people living with HIV.

Instead of requiring patients to visit designated HIV treatment centres every time they need a refill, approved pharmacies could serve as alternative collection points.

Patients would still be registered with an accredited HIV treatment facility, where their medical records, prescriptions and clinical progress would be monitored. However, they could choose a participating pharmacy closer to their homes or workplaces to collect their medication.

This would reduce unnecessary visits to specialised treatment centres and give patients greater control over how they access their medication. Interestingly, this is not an entirely new idea.

Ghana’s own HIV treatment guidelines already recognise community pharmacies as potential ART refill points.

The Ghana Health Service’s 2022 Differentiated Service Delivery for HIV in Ghana operational manual provides for people who are established on treatment to collect their medication from health centres, Community-based Health Planning and Services (CHPS) compounds, drop-in centres and designated community pharmacies.

The guidelines also provide for home delivery with the patient’s written consent. In other words, Ghana already has a policy framework that recognises the importance of taking HIV treatment beyond conventional hospital and clinic settings. The challenge is to ensure that these options are accessible and adequately implemented.

There are encouraging signs that the country is beginning to recognise the potential of community pharmacies in the national HIV response.

On July 23, 2026, the Pharmaceutical Society of Ghana and the Ghana AIDS Commission held discussions on how pharmacists and community pharmacies could be integrated into HIV prevention, testing, treatment and adherence support.

Among the proposals considered were ART refill distribution through appropriately trained and accredited pharmacies, as well as drop-in medicine collection arrangements. The Pharmaceutical Society highlighted the fact that pharmacies could reach people who avoid conventional HIV treatment centres because of distance, inconvenience or fear of being identified.

The discussions also considered how pharmacists could support public education, HIV testing, referrals and access to other HIV prevention services. These proposals were reported in the Pharmaceutical Society of Ghana’s official journal in August 2026.

This is an important development. Rather than building an entirely new system, Ghana could expand existing differentiated service delivery arrangements and make them more accessible.

If HIV self-testing kits can be ordered and delivered to people’s homes, why can’t the same convenience be extended to antiretroviral medication?

Imagine a situation where a person living with HIV can log into a secure healthcare platform, request a refill and have the medication delivered to a designated address without having to visit a treatment centre.

For someone who lives in a community where HIV carries considerable social stigma, such an arrangement could make a tremendous difference. It could also benefit people with demanding work schedules, those living far from treatment centres, people with mobility difficulties and individuals who travel frequently.

The proposed system could operate through a secure online platform managed by the Ghana Health Service, accredited healthcare providers or authorised pharmacy partners. Patients would register using their existing treatment identification details. Their prescriptions would be verified by authorised healthcare professionals before medication is dispatched.

Deliveries could be made in discreet packaging without any visible indication that the contents are HIV medication. Patients could also choose collection from a participating pharmacy or another agreed location.

Importantly, patients should be able to decide how they receive their medication. Some may prefer home delivery, while others may feel more comfortable collecting it from a pharmacy. The objective should be to give patients options rather than impose another system on them.

However, making ART available online should not be interpreted as allowing people to purchase antiretroviral drugs as ordinary over-the-counter medication. HIV treatment is a lifelong medical intervention that requires appropriate prescriptions, adherence support and periodic clinical monitoring.

People newly diagnosed with HIV must be linked to accredited treatment facilities for assessment, counselling and initiation of treatment. Patients who have just started medication or are experiencing complications may require closer clinical supervision.

Ghana’s differentiated service delivery guidelines provide that patients who have been successfully established on ART for at least six months, have no current illness requiring closer attention, understand the importance of adherence and demonstrate treatment success through viral load monitoring can access less frequent clinical appointments and alternative refill arrangements.

For eligible patients, the guidelines recommend clinical reviews every six months and medication refills of at least three months. Six-month refills may also be provided where drug supplies allow.

This means that patients do not necessarily need to visit a health facility every month to collect their medication.

There are also legal considerations. Under Ghana’s AIDS Commission Regulations, 2020 (L.I. 2403), HIV treatment must be provided through accredited public or private health facilities and approved community channels.

Consequently, any expansion of online delivery or pharmacy-based distribution must operate within the country’s regulatory framework, with appropriate accreditation, prescriptions and clinical oversight. The distinction is important: the goal is not to remove medical supervision but to remove unnecessary barriers between patients and their medication.

One of the greatest concerns surrounding online ART delivery would be the protection of patients’ identities and medical information. A poorly designed delivery system could actually worsen the stigma it seeks to address.

For example, what happens if a delivery company discloses the contents of a package? What if a patient’s HIV status is exposed through an online account, payment record or careless handling of medical information?

These are legitimate concerns that must be addressed before such a programme is introduced. The proposed system must have strict confidentiality requirements, secure patient records, restricted access to medical information and appropriate penalties for breaches.

Delivery personnel should not be required to know a patient’s HIV status. Packages should be discreet, and patients should have control over delivery addresses, collection arrangements and communication preferences.

Participation must also be voluntary. Some patients may prefer the traditional hospital-based system, while others may welcome the opportunity to receive treatment privately. The system must accommodate both groups.

While improving access to medication is important, Ghana must not overlook the reasons some people abandon treatment in the first place.

Some patients struggle with accepting their HIV status. Others experience discrimination from family members, partners and communities. There are also individuals who stop taking medication because they mistakenly believe that feeling healthy means they are cured.

Public education must therefore become a central part of the national response. People living with HIV must understand that antiretroviral therapy does not cure the infection but suppresses the virus, allowing them to live long and healthy lives.

Importantly, scientific evidence shows that people who maintain an undetectable viral load through effective treatment do not sexually transmit HIV. This principle, commonly known as Undetectable = Untransmittable (U=U), is an important message that can help reduce fear and discrimination.

Partners of people living with HIV should also be encouraged to access appropriate HIV testing, counselling and prevention services.

Equally, people who have stopped treatment should be encouraged to return to care without fear of condemnation. The health system should make re-engagement easier rather than make patients feel ashamed of their treatment interruptions.

Ghana does not necessarily need to begin with a nationwide online ART delivery programme. A carefully designed pilot could help establish whether the approach is practical, safe and effective.

The Ghana Health Service, Ghana AIDS Commission, National AIDS/STI Control Programme and Pharmaceutical Society of Ghana could collaborate to introduce a pilot involving selected accredited pharmacies and healthcare facilities.

The programme could initially target patients who are already established on ART and eligible for differentiated service delivery.

It should explore three complementary arrangements:

1. Community pharmacy collection: Patients receive their medication from accredited pharmacies closer to their homes or workplaces.

2. Online ordering and home delivery: Eligible patients request refills through a secure platform and receive medication in discreet packaging.

3. Remote treatment support: Patients receive appointment reminders, adherence support and opportunities to consult healthcare professionals remotely, while still attending scheduled clinical assessments and laboratory tests.

The pilot should measure whether these arrangements improve treatment adherence, reduce missed appointments, protect confidentiality and increase patient satisfaction.

The availability of medication must also be guaranteed. There would be little value in introducing an online ordering system if patients regularly receive notifications that their medication is unavailable.

The government must therefore strengthen procurement, distribution and supply-chain management to ensure uninterrupted access to antiretroviral medicines.

The fight against HIV cannot be won through medication alone. It requires an environment in which people are comfortable getting tested, accepting their status, starting treatment and remaining on medication without fear of discrimination.

The accounts shared by the two women on Auntie Naa’s Oyerepa Afutuo programme should prompt a wider national conversation about how Ghana can improve treatment adherence and prevent avoidable infections.

It is also important to recognise that people living with HIV are not a threat to society simply because of their status. With proper treatment and support, they can lead healthy, productive lives and have relationships and families.

If fear of being seen at an HIV treatment centre is keeping people away from medication, then the health system must find ways to make treatment more discreet and convenient.

Ghana has already recognised the value of differentiated HIV service delivery. Its guidelines provide for community pharmacy refills and even home delivery with patients’ consent. Discussions between the Ghana AIDS Commission and the Pharmaceutical Society of Ghana also suggest that there is growing interest in expanding the role of pharmacists.

The next step should be to move beyond discussions and examine how these options can be made available to more people.

Perhaps it is time to make HIV treatment as accessible as other essential healthcare services, including through secure online ordering and home delivery.

After all, the ultimate objective should not simply be to get people to hospitals to collect medication. It should be to ensure that everyone living with HIV can access treatment, remain on it and live without fear of being exposed or discriminated against.

And if technology can help achieve that, why should Ghana not explore it?

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