Objective: To understand, by qualitative enquiry, the underlying reasons and narratives for patients that delay in accessing antiretroviral treatment.

Design: A qualitative design was used, where patients were interviewed using the free attitude interview technique, after being selected based on a screening question: “How long did it take you to present at a clinic or hospital for treatment after receiving your human immunodeficiency virus-positive result?”

Setting and subjects: Eight patients from the human immunodeficiency virus clinic at Potchefstroom were interviewed.

Outcome measures: The interviews were transcribed verbatim and organised into themes.

Results: The following themes were identified: stigma and discrimination, ignorance and lack of perceived risk of infection, denial and healthcare system constraints. These are discussed and quotations from the interviewed patients included.

Conclusion: This qualitative study has contributed to an understanding of why patients delay in accessing highly active antiretroviral therapy. Some of the reasons supplied by patients have been documented globally. Others are poignantly coloured by personal stories. By understanding patients' perspectives and feelings, emphasis can be placed on the reduction of stigma, denial, practical clinic constraints and appropriate types of health education.