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Assessing Social Preparedness for Antiretroviral Therapy in a Generalized AIDS Epidemic: A Diffusion of Innovations Approach


Researchers conducted focus groups in the Eastern Cape Province of South Africa concerning AIDS and treatment options. Constituent groups included adults aged 25–45, HIV/AIDS caregivers, HIV-positive adults, nurses, rural elders, teenagers, and traditional healers. This pilot work aimed to gather early evidence on perceptions about the government’s rollout of antiretroviral treatment (ART), identify potential barriers to success, and inform a subsequent pilot survey. Diffusion of innovations theory was used to interpret the data and helped identify potential obstacles to the ART rollout. AIDS stigma and a weakened healthcare system were negatively impacting the program. There was a lack of accurate knowledge about HIV/AIDS and antiretroviral treatment, with wide disparities among groups. Many people were not convinced that antiretroviral treatment is superior to other treatments, and a few people were afraid it was poisonous. There was no evidence that people were aware of the long-term difficulties of adherence to the regimen.

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The authors would like to thank the editor and two anonymous referees for comments and helpful advice and the Office of the Vice President for Research at Virginia Commonwealth University for financial support.

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Correspondence to Shannon K. Mitchell.

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Mitchell, S.K., Kelly, K.J., Potgieter, F.E. et al. Assessing Social Preparedness for Antiretroviral Therapy in a Generalized AIDS Epidemic: A Diffusion of Innovations Approach. AIDS Behav 13, 76–84 (2009).

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  • AIDS
  • South Africa
  • Antiretroviral therapy
  • Diffusion of innovations
  • Traditional medicine