Why Do HIV-Naïve Patients in Phayao, Thailand Delay Initiating Antiretroviral Therapy (ART)?

Abstract

Early treatment extends life expectancy for people living with HIV/AIDS, but many of them delay treatment initiation. We describe the characteristics, HIV status, and reasons for delaying and starting antiretroviral treatment (ART) among patients with HIV who were treatment-naïve and enrolled in an intervention study at HIV Clinic of Phayao Hospital, Thailand. The 23 participants were 18-54 years of age. Median CD4 cell count was 55 /mm³ (range 6-218 /mm³) when starting ART. Eleven patients were HIV-infected patients, who returned to receive treatment, and 12 patients were newly diagnosed with HIV. Among these twelve, eight suspected they were HIV positive but delayed seeking a diagnosis. Common reasons patients gave for delaying ART were that they did not know they were eligible and they had no symptoms. The most common reason for initiating ART was to be healthy. Late diagnosis of HIV infection and insufficient HIV healthcare information were reasons for delaying ART initiation among HIV-naïve patients in Phayao. Free treatments and availability of health services and medications did not assure that HIV-naive patients would decide to start taking ART.