摘要：Deciding to initiate antiretroviral treatment (ART) for HIV involves a number of factors, including how one thinks about disease (illness appraisals) and how one thinks about treatment (medication appraisals). We conducted semi-structured interviews with 20 adults who were deciding whether to begin ART, in which participants were asked to relate their experience of testing positive, their experience with medications other than ART, and their thoughts about ART. Digital recordings were transcribed for team-based narrative analysis. In response to HIV+ diagnosis, participants described the following appraisals: 1) HIV is a threat to mortality; 2) nonacceptance of the HIV diagnosis; 3) HIV is associated with stigma and rejection; and, 4) the HIV diagnosis meant betrayal by a cared for other. Medication appraisals included: 1) negative feelings about medications in general, 2) taking HIV medication would create a personal crisis; 3) the benefits of taking HIV medication would not outweigh the costs; 4) doubts whether they could adhere, and 5) taking medications would be stigmatizing. Illness and medication appraisals may represent barriers to initiating and adhering to treatment and should be taken into account in helping clients to cope with their diagnosis and manage their healthcare.
关键词：Antiretroviral Therapy; HIV/AIDS; Health Care Utilization; Illness Appraisals
