Lambert, R.F., Orrell, C., Bangsberg, D.R., et al. AIDS and Behavior (February 2017), doi:10.1007/s10461-017-1704-y.
To clarify factors motivating healthy individuals to seek HIV testing and treatment, the authors conducted in-depth interviews with 25 HIV-positive young adults (age 18–35 years) with a CD4 count >350 cells/mm3 who recently started or decided to start antiretroviral therapy in Gugulethu, South Africa. They found that several factors influenced a participant’s decision to seek testing. Avoiding stigma (by appearing healthy) was a primary motivator. Other factors included social support—a close associate who advocated testing—responsibility for a child or desire to be healthy and achieve goals and aspirations, the perceived "normalcy" of having HIV, and availability of accessible services. Participants also mentioned concerns about side effects from treatment or the difficulty of maintaining the medication schedule as barriers requiring serious thought. The authors noted that stigma can serve as both a barrier and a motivator for testing and treatment. They said that the study shows the importance of health maintenance as a driver of early treatment initiation, and urged including maintenance of physical appearance in the development of novel testing and treatment interventions.