ArticleAIDS and behavior2015
Understanding treatment refusal among adults presenting for HIV-testing in Soweto, South Africa: a qualitative study.
Article in AIDS and behavior, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
59 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Men missing from the HIV care continuum in sub-Saharan Africa: a meta-analysis and meta-synthesis.Journal of the International AIDS Society · 2022Pooled it
- Why do people living with HIV not initiate treatment? A systematic review of qualitative evidence from low- and middle-income countries.Social science & medicine (1982) · 2018Pooled it
- Trial
- Changing contextual factors from baseline to 9-months post-HIV diagnosis predict 5-year mortality in Durban, South Africa.AIDS care · 2021Trial
- The Treatment Ambassador Program: A Highly Acceptable and Feasible Community-Based Peer Intervention for South Africans Living with HIV Who Delay or Discontinue Antiretroviral Therapy.AIDS and behavior · 2021Trial
- Predictors of Viremia in Postpartum Women on Antiretroviral Therapy.Journal of acquired immune deficiency syndromes (1999) · 2020Trial
- Assessing rates and contextual predictors of 5-year mortality among HIV-infected and HIV-uninfected individuals following HIV testing in Durban, South Africa.BMC infectious diseases · 2019Trial
- Understanding the Time Needed to Link to Care and Start ART in Seven HPTN 071 (PopART) Study Communities in Zambia and South Africa.AIDS and behavior · 2019Trial
- Barriers and facilitators to the uptake of Test and Treat in Mozambique: A qualitative study on patient and provider perceptions.PloS one · 2018Trial
- HIV-related stigma and universal testing and treatment for HIV prevention and care: design of an implementation science evaluation nested in the HPTN 071 (PopART) cluster-randomized trial in Zambia and South Africa.Health policy and planning · 2016Trial
- A meta-intervention to increase completion of an HIV-prevention intervention: Results from a randomized controlled trial in the state of Florida.Journal of consulting and clinical psychology · 2016Trial
- Article
- A Risk Prediction Model to Identify People Living with HIV Who are High-risk for Disengagement from Care after HIV Diagnosis in South Africa.AIDS and behavior · 2024Article
- Improving patient-centred counselling skills among lay healthcare workers in South Africa using the Thusa-Thuso motivational interviewing training and support program.PLOS global public health · 2024Article
- An assessment on the implementation of same day antiretroviral therapy initiation in eThekwini clinics, KwaZulu-Natal, South Africa.Journal of public health in Africa · 2023Article
- Understanding the Unique Barriers and Facilitators that Affect Men's Initiation and Retention in HIV Care: A Qualitative Study to Inform Interventions for Men Across the Treatment Cascade in Malawi.AIDS and behavior · 2023Article
- Traditional and biomedical health practices of adolescent boys and young men living with perinatally-acquired HIV in the Eastern Cape Province of South Africa.Global public health · 2023Article
- 'I need time to start antiretroviral therapy': understanding reasons for delayed ART initiation among people diagnosed with HIV in Lusaka, Zambia'.Annals of medicine · 2022Article
- Understanding Repeat Positive HIV Testing in South Africa Under Changing Treatment Guidelines.AIDS and behavior · 2022Article
- Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
HIV treatment initiatives have focused on increasing access to antiretroviral therapy (ART). There is growing evidence, however, that treatment availability alone is insufficient to stop the epidemic. In South Africa, only one third of individuals living with HIV are actually on treatment. Treatment refusal has been identified as a phenomenon among people who are asymptomatic, however, factors driving refusal remain poorly understood. We interviewed 50 purposively sampled participants who presented for voluntary counseling and testing in Soweto to elicit a broad range of detailed perspectives on ART refusal. We then integrated our core findings into an explanatory framework. Participants described feeling "too healthy" to start treatment, despite often having a diagnosis of AIDS. This subjective view of wellness was framed within the context of treatment being reserved for the sick. Taking ART could also lead to unintended disclosure and social isolation. These data provide a novel explanatory model of treatment refusal, recognizing perceived risks and social costs incurred when disclosing one's status through treatment initiation. Our findings suggest that improving engagement in care for people living with HIV in South Africa will require optimizing social integration and connectivity for those who test positive.
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