@article{85e62edbe4f944d5b809bedbfcc6ec6a,
title = "Factors that Motivated Otherwise Healthy HIV-Positive Young Adults to Access HIV Testing and Treatment in South Africa",
abstract = "The World Health Organization recommends early initiation of HIV antiretroviral therapy (ART) for all those infected with the virus at any CD4 count. Successfully reaching individuals with relatively high CD4 counts depends in large part on healthy individuals seeking testing and treatment; however, little is known about factors motivating this decision. We conducted a qualitative study to explore this issue among 25 young HIV-positive adults (age 18–35) with a CD4 count >350 cells/mm3 who recently started or made the decision to start ART in Gugulethu, South Africa. Using an inductive content analytical approach, we found that most individuals sought testing and treatment early in the disease progression because of a desire to appear healthy thereby avoiding stigma associated with AIDS. Other factors included social support, responsibilities and aspirations, normalcy of having HIV, and accessible services. These findings suggest that maintenance of physical appearance should be included in the development of novel testing and treatment interventions.",
keywords = "Access to care, Antiretroviral therapy, Human immunodeficiency virus, South Africa, Young adults",
author = "Lambert, {R. Frederick} and Catherine Orrell and Bangsberg, {David R.} and Haberer, {Jessica E.}",
note = "Funding Information: Conflict of interest R. Frederick Lambert declares that he has no conflict of interest. Catherine Orrell receives grant funding from Desmond Tutu HIV Foundation and the University of Cape Town. She declares that she has no conflict of interest. David R. Bangsberg declares that he has no conflict of interest. Jessica E. Haberer receives grant funding from NIH, the Gates Foundation, and USAID. She has received consulting fees from Merck, the WHO and the NIH. She own Funding Information: Acknowledgements All authors contributed to the conception and design of the study, data analysis and interpretation, and/or development of the manuscript. The manuscript was drafted by R.F.L. and J.E.H. All authors critically reviewed the manuscript, suggested revisions and editorial changes, and approved the final version. The authors gratefully acknowledge Vivie Situlo, who collected qualitative data, and the following study staff: Nicola Kelly, Anna Cross, Zoleka Xapa, Pearl Pahlana, Ingrid Courtney, Nomsa Ngwenya, Nosiphiwo Mzamo, Alienah Mpahleni and other members of the {\textquoteleft}Examining HIV Treatment Adherence During Early Disease{\textquoteright} study team. Financial support for the qualitative research presented here was provided by the Bill and Melinda Gates Foundation (J.E.H., C.O.), the Harvard Medical School Class of 1984 Scholarship (R.F.L.) and the Harvard Medical School Center for Primary Care (R.F.L.). Funding Information: All authors contributed to the conception and design of the study, data analysis and interpretation, and/or development of the manuscript. The manuscript was drafted by R.F.L. and J.E.H. All authors critically reviewed the manuscript, suggested revisions and editorial changes, and approved the final version. The authors gratefully acknowledge Vivie Situlo, who collected qualitative data, and the following study staff: Nicola Kelly, Anna Cross, Zoleka Xapa, Pearl Pahlana, Ingrid Courtney, Nomsa Ngwenya, Nosiphiwo Mzamo, Alienah Mpahleni and other members of the ?Examining HIV Treatment Adherence During Early Disease? study team. Financial support for the qualitative research presented here was provided by the Bill and Melinda Gates Foundation (J.E.H., C.O.), the Harvard Medical School Class of 1984 Scholarship (R.F.L.) and the Harvard Medical School Center for Primary Care (R.F.L.). This study was funded by the Bill and Melinda Gates Foundation (Grant No. OPP113634) and Harvard Medical School Center for Primary Care. R. Frederick Lambert declares that he has no conflict of interest. Catherine Orrell receives grant funding from Desmond Tutu HIV Foundation and the University of Cape Town. She declares that she has no conflict of interest. David R. Bangsberg declares that he has no conflict of interest. Jessica E. Haberer receives grant funding from NIH, the Gates Foundation, and USAID. She has received consulting fees from Merck, the WHO and the NIH. She own stock in Natera. She declares that these financial interests do not constitute a conflict of interest. Publisher Copyright: {\textcopyright} 2017, Springer Science+Business Media New York. Copyright: Copyright 2018 Elsevier B.V., All rights reserved.",
year = "2018",
month = mar,
day = "1",
doi = "10.1007/s10461-017-1704-y",
language = "English (US)",
volume = "22",
pages = "733--741",
journal = "AIDS and Behavior",
issn = "1090-7165",
publisher = "Springer New York",
number = "3",
}