AIDS and Behavior

, Volume 19, Issue 5, pp 821–831 | Cite as

Understanding Concerns About Treatment-as-Prevention Among People with HIV who are not Using Antiretroviral Therapy

  • C. E. NewmanEmail author
  • J. de Wit
  • A. Persson
  • M. Holt
  • S. Slavin
  • M. R. Kidd
  • J. J. Post
  • E. Wright
  • L. Mao
Original Paper


The use of antiretroviral therapy to prevent HIV transmission is now advocated in many settings, yet little research has documented the views of people with HIV. Semi-structured interviews were conducted in Australia between 2012 and 2014 with 27 HIV-positive people not using treatment at the time of interview. Thematic analysis of views on treatment-as-prevention found that while many participants recognised potential prevention benefits, only a minority was in support of initiating treatment solely to achieve those benefits. A range of uncertain or critical views were expressed regarding who would benefit, risk reduction, and changing treatment norms. Participants resisted responsibility narratives that implied treatment should be used for the public good, in favour of making considered decisions about their preferred approach to managing HIV. Engaging communities in dialogue and debate regarding the risks and benefits of treatment will be critical if this new prevention strategy is to engender public trust.


HIV treatment as prevention People living with HIV Australia Qualitative 



Many thanks to the people who took part in interviews for this study, and colleagues who helped with recruitment, particularly the National Association of People with HIV Australia. Our thanks also go to Professor David Wilson (The Kirby Institute, UNSW Australia), who also is Chief Investigator on this study, and to all members of the study’s Advisory Committee and their organisations: NSW Health, Australian Federation of AIDS Organisations, Heterosexual HIV/AIDS Service NSW (PozHet) and Positive Life NSW. The study was partly funded by a Project Grant (1021790) from the National Health and Medical Research Council. Centre for Social Research in Health projects are partly or fully funded by the Australian Government Department of Health.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • C. E. Newman
    • 1
    Email author
  • J. de Wit
    • 1
  • A. Persson
    • 1
  • M. Holt
    • 1
  • S. Slavin
    • 1
    • 2
  • M. R. Kidd
    • 3
  • J. J. Post
    • 4
    • 5
  • E. Wright
    • 6
    • 7
  • L. Mao
    • 1
  1. 1.Centre for Social Research in HealthUNSW AustraliaSydneyAustralia
  2. 2.Australian Federation of AIDS OrganisationsSydneyAustralia
  3. 3.Faculty of Medicine, Nursing and Health SciencesFlinders UniversityAdelaideAustralia
  4. 4.Department of Infectious DiseasesThe Prince of Wales HospitalSydneyAustralia
  5. 5.Prince of Wales Clinical SchoolUNSW AustraliaSydneyAustralia
  6. 6.Department of Infectious DiseasesThe Alfred Hospital and Monash UniversityMelbourneAustralia
  7. 7.The Burnet InstituteMelbourneAustralia

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