Unlocking the Keys to Swift HIV Treatment: A Qualitative Exploration of Rapid Antiretroviral Therapy Initiation Among People Living with HIV in China.

Background: Rapid initiation of antiretroviral therapy (ART) is beneficial for people living with HIV (PLWH) to achieve the virological suppression and decrease the risk of HIV transmission. However, the implementation of rapid ART varies across the world. Objective: This study aims to understand the influencing factors of rapid start of ART in PLWH in Liangshan Prefecture, where the HIV epidemic is severe and is a key area for HIV prevention and control in China, to provide information for making effective interventions in China and elsewhere. Methods: A phenomenological study with semi-structured in-depth interviews was conducted in Liangshan Prefecture, Sichuan Province, China, from April 2024 to May 2024. Data were analyzed by using the Colaizzi's seven-step method. Results: Participants (n = 27) aged 14-55 were interviewed (14 males and 13 females). Participants initiated ART at a median time of 29 days. 15 participants initiated ART within 30 days of HIV diagnosis, but no one initiated ART within seven days of HIV diagnosis. Three themes and nine sub-themes affecting the rapid start of ART were identified: capacity factors (physical condition, disease knowledge, psychological resilience); opportunity factors (affordability of medicines, policy timeliness, diagnosis disclosure and social support, attitudes of healthcare workers); and motivation factors (family roles, benefit perception of ART). Conclusion: Influencing factors affecting the rapid initiation of ART in PLWH were complex. Healthcare providers should strengthen the knowledge education from the perspective of PLWH, pay more attention to the psychological changes after they are diagnosed with HIV infection, improve their social support network, alleviate their treatment burden, help them make scientific decisions, and promote the implementation of rapid initiation of ART.