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

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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.

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Acknowledgements

The authors gratefully acknowledge the staff of the Tutu Tester Mobile Clinic for their valuable assistance with developing the study materials and with data collection.

Funding

This study was partially funded by the National Research Foundation, South Africa, through the Research Career Advancement Fellowship. Data collection for this study was partially funded by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health (award number R24HD077976). Support was provided by the National Institutes of Health through the Brown University Population Studies and Training Center (PSTC) (P2CHD041020-16). Support was provided to CK and ML by the National Institute of Mental Health of the National Institutes of Health (award numbers K01096646 and 1R01 MH106600-01). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Southern Africa Labour and Development Research Unit, University of Cape Town, Private Bag Rondebosch, Cape Town, 7701, South Africa

    Brendan Maughan-Brown

  2. The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa

    Philip Smith & Linda-Gail Bekker

  3. Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA

    Caroline Kuo & Abigail Harrison

  4. Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa

    Caroline Kuo

  5. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA

    Mark N. Lurie

  6. Department of Health Services, Policy & Practice (HSPP), Brown University School of Public Health, Providence, RI, USA

    Omar Galárraga

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Correspondence to Brendan Maughan-Brown.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Human Research Ethics Committee, Faculty of Health Sciences, University of Cape Town provided study approval (ref: 849/2014).

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Informed consent was obtained from all individual participants included in the study.

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Maughan-Brown, B., Smith, P., Kuo, C. et al. Readiness for Antiretroviral Therapy: Implications for Linking HIV-Infected Individuals to Care and Treatment. AIDS Behav 22, 691–700 (2018). https://doi.org/10.1007/s10461-017-1834-2

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