False starts in 'test and start': a qualitative study of reasons for delayed antiretroviral therapy in Swaziland.
In: International Health (1876-3413), Jg. 10 (2018-03-01), Heft 2, S. 78-83
Online
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Zugriff:
Background: Test and start, antiretroviral therapy (ART) for all HIV-positive individuals, is a WHO-recommended treatment guideline. In Swaziland, test and start has been evaluated through the MaxART implementation study. This article examines why, in MaxART, some newly diagnosed HIV-positive clients delayed initiating ART. Methods: Thirteen HIV-positive clients who delayed ART for =90 d after testing were identified from the MaxART study database and interviewed. Interviews were audio recorded, transcribed and translated into English for qualitative content analysis. Results: Respondents had often tested positive several times before initiating ART, with the initial diagnosis sometimes completely unexpected. Repeat testing--and delayed ART--was linked to a desire to come to terms with their diagnosis and prepare for a lifelong treatment course. Clients previously enrolled in pre-ART, particularly with high CD4 counts, had internalized past messages about ART as being non-essential and taking care of oneself through other means. Concerns about ART-related adverse events were weighed against these messages. Worries about inadvertent disclosure and its impact on social and economic relationships also discouraged initiation. Conclusion: Although potentially reducing logistical barriers, expedited ART initiation does not necessarily accommodate some clients' need for time to come to terms with the diagnosis and the prospect of lifelong treatment. [ABSTRACT FROM AUTHOR]
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Titel: |
False starts in 'test and start': a qualitative study of reasons for delayed antiretroviral therapy in Swaziland.
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Autor/in / Beteiligte Person: | Pell, Christopher ; Vernooij, Eva ; Masilela, Nelisiwe ; Simelane, Njabulo ; Shabalala, Fortunate ; Reis, Ria |
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Zeitschrift: | International Health (1876-3413), Jg. 10 (2018-03-01), Heft 2, S. 78-83 |
Veröffentlichung: | 2018 |
Medientyp: | academicJournal |
ISSN: | 1876-3413 (print) |
DOI: | 10.1093/inthealth/ihx065 |
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