FRAD0101 | THROUGH OUR EYES: EXPLORING THE EXPERIENCES OF YOUNG WOMEN LIVING WITH HIV IN LOWER MANYA KROBO (GHANA) USING PHOTOVOICE

Rachel Lawerh | University of Ottawa, Canada

Young women and girls living with HIV (YWLHIV) in Ghana face multifaceted challenges in accessing sexual and reproductive health (SRH) services. These are compounded by stigma, economic hardship, and systemic barriers. Nationally, young women (ages 15–24) account for one-quarter of all new HIV infections. While the national HIV prevalence is 1.5%, in Lower Manya Krobo (LMK), this is higher at 5.3%, highlighting the need for context-specific understanding and interventions. Traditional research methods often fail to capture the depth and complexity of the lived experiences of YWLHIV living in this municipality. This qualitative study used photovoice to engage 10 YWLHIV aged 15–24 in Lower Manya Krobo. Participants captured photographs that symbolized their SRH experiences, including their daily lives, fears, hopes, and barriers to care. In-depth interviews followed, allowing participants to narrate the meaning and connections of their photographs to their experiences. Five key informant interviews (KIIs) were conducted with healthcare providers, policymakers, and program leads to provide contextual insights into the structural barriers and gaps within and beyond the healthcare system. Thematic analysis was used to interpret the data from the photographs and interviews. The photovoice process revealed layered and intersecting challenges: some participants accessed contraceptives like injectables and implants, but others avoided them due to fears of side effects or cultural myths. Fear of disclosing HIV status to family or partners led to social isolation, captured in images of empty chairs and shadows. Economic and food insecurity posed significant barriers to SRH care and adherence to antiretroviral therapy, with some participants skipping medication when lacking food. Motherhood brought both joy and new responsibilities, depicted through baby items that highlighted the balancing act between caregiving, health, and stigma. Photovoice showed the nuanced SRH journeys of YWLHIV in Lower Manya Krobo, showing how stigma, economic hardship, and misinformation shape their reproductive lives and access to care. Integrating peer-led support and culturally sensitive counseling is critical for addressing these barriers. Recommendations: Implement community-based, peer-led SRH education tailored to the needs of YWLHIV. Train healthcare providers to offer inclusive SRH services that respect the complexities of lived experiences.