Barriers and Facilitators to HIV Prevention Services Among Key Populations in Biakoye District, Ghana

Key populations such as sex workers, men who have sex with men (MSM), women who have sex with women (WSW), and people who inject drugs (PWID) bear a disproportionately high burden of HIV infection. Despite the availability of HIV prevention services in Ghana, access and utilization remain limited, particularly in rural settings. This cross-sectional study conducted in April 2025 assessed barriers and facilitators to HIV prevention service utilization among 43 key population members in Biakoye District. Data were collected through a structured questionnaire and analyzed using descriptive statistics, chi-square tests, and logistic regression. Participants had a mean age of 25.2 years; most were female (65.1%) and sex workers (72.1%). Although 93% had heard of HIV prevention methods, only 62.8% had ever used prevention services. Key barriers included lack of awareness (48.8%), fear of stigma or discrimination (48.8%), long waiting times (36.1%), transportation challenges (29.5%), and confidentiality concerns (34.9%). Higher education (aOR = 2.60, 95% CI: 0.41-4.73, p = 0.020) and knowledge of service locations (aOR = 1.55, 95% CI: 0.08-3.03, p = 0.039) were significantly associated with utilization. Findings highlight persistent structural and social barriers impeding service uptake among key populations and underscore the need for stigma reduction, improved accessibility, and community-based HIV prevention models in rural districts.