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AIDS Behav. 2018 Mar;22(3):691-700. doi: 10.1007/s10461-017-1834-2.

Readiness for Antiretroviral Therapy: Implications for Linking HIV-Infected Individuals to Care and Treatment.

Author information

1
Southern Africa Labour and Development Research Unit, University of Cape Town, Private Bag Rondebosch, Cape Town, 7701, South Africa. brendan.maughanbrown@gmail.com.
2
The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
3
Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
4
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
5
Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
6
Department of Health Services, Policy & Practice (HSPP), Brown University School of Public Health, Providence, RI, USA.

Abstract

Using survey data collected immediately after referral for ART (N = 87), this study examined ART-readiness among individuals (18 years and older) attending a mobile health clinic in South Africa. Most participants reported being very ready (84%) and motivated (85%) to start ART, but only 72% were assessed as ready for ART on all measures. Treatment readiness was lower among individuals who did not think they would test HIV-positive (aOR 0.26, p < 0.05) and among individuals who reported being in good health (aOR 0.44, p < 0.1). In contrast, higher readiness was associated with better ART knowledge (aOR 4.31, p < 0.05) and knowing someone who had experienced positive health effects from ART (aOR 2.65, p < 0.05). Results indicate that post-test counselling will need to be designed to deal with surprise at HIV diagnosis, and that health messaging needs to be carefully crafted to support uptake of ART among HIV-positive but healthy individuals. Further research is needed on effective post-test counselling approaches and effective framing of health messaging to increase awareness of the multiple positive benefits of early ART initiation and corresponding readiness to engage in treatment.

KEYWORDS:

Barriers to ART initiation; HIV/AIDS; Linkage to care; Treatment readiness

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