Effectiveness of a Social Media–Based Peer Support Intervention for Improving Medication Adherence and Health-Related Quality of Life among Young People Living with HIV in Ghana: A Single-Group Pretest–Posttest Quasi-Experimental Study

Abstract Background: Young people living with HIV (YPLHIV) frequently encounter barriers to antiretroviral therapy (ART) adherence and experience suboptimal health-related quality of life (HRQoL), which together undermine viral suppression and long-term prognosis. While peer support interventions can enhance engagement in HIV care, empirical data regarding social media–facilitated peer networks among YPLHIV in sub-Saharan Africa remain scarce. This study evaluated the effectiveness of a structured, professionally moderated social media–based peer support intervention designed to enhance medication adherence and HRQoL among YPLHIV receiving ART in Ghana Methods: A single-group pretest–posttest quasi-experimental study was conducted among 124 young adults aged 18–34 years attending the HIV Clinic of Kade Government Hospital in the Kwaebibirim Municipality, Ghana. The six-month intervention utilized Chatterbox (for anonymous group interactions) and WhatsApp (for confidential one-on-one professional counselling). Medication adherence was evaluated using the 10-item Medication Adherence Rating Scale (MARS-10), and HRQoL was assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Pre- and post-intervention outcomes were compared using paired t-tests, Wilcoxon signed-rank tests, and McNemar’s tests. Population-averaged generalized estimating equations (GEE) with a log link, Poisson family, and robust standard errors were fitted to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for factors associated with poor medication adherence and poor HRQoL. Results: Following the six-month intervention, the proportion of participants achieving good medication adherence rose from 21.1% (26/124) to 78.9% (98/124; p<0.001). Statistically significant gains occurred across all four WHOQOL-BREF domains (all p<0.001). The overall prevalence of poor HRQoL declined from 96.8% to 3.2% (p<0.001). Medication adherence correlated positively with physical (r=0.660), psychological (r=0.752), social (r=0.623), and environmental (r=0.730) health domains (all p<0.001). In multivariable GEE modeling, the post-intervention period was independently associated with an 80% reduction in the prevalence of poor medication adherence (aPR = 0.20, 95% CI: 0.12–0.34) and a 96% reduction in poor overall HRQoL (aPR = 0.04, 95% CI: 0.01–0.13). Participants with unsuppressed viral load (≥50 copies/mL) were over twice as likely to experience poor adherence as suppressed peers (aPR = 2.31, 95% CI: 1.58–3.39). Never-married participants had a lower prevalence of poor HRQoL than those who were married or cohabiting (aPR = 0.86, 95% CI: 0.75–0.99). Conclusion: A structured, multidisciplinary social media peer-support intervention was associated with substantial improvements in medication adherence, HRQoL, and virological suppression among young people living with HIV. Integrating digital peer networks into routine differentiated service delivery represents an effective and scalable avenue for youth-centered HIV care in resource-limited environments.