title: Understanding Concerns About Treatment-as-Prevention Among People with HIV who are not Using Antiretroviral Therapy.
abstract: 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.
authors.affiliation: Centre for Social Research in Health, UNSW Australia, Level 2 John Goodsell Building, Sydney, NSW, 2052, Australia, c.newman@unsw.edu.au.
authors.forename: C E
authors.initials: CE
authors.lastname: Newman
authors.forename: J
authors.initials: J
authors.lastname: de Wit
authors.forename: A
authors.initials: A
authors.lastname: Persson
authors.forename: M
authors.initials: M
authors.lastname: Holt
authors.forename: S
authors.initials: S
authors.lastname: Slavin
authors.forename: M R
authors.initials: MR
authors.lastname: Kidd
authors.forename: J J
authors.initials: JJ
authors.lastname: Post
authors.forename: E
authors.initials: E
authors.lastname: Wright
authors.forename: L
authors.initials: L
authors.lastname: Mao
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001315:Australia; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D036301:Qualitative Research; D012044:Regression Analysis; D040242:Risk Reduction Behavior
chemical_list: D019380:Anti-HIV Agents