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Understanding Treatment Refusal Among Adults Presenting For Hiv-Testing In Soweto, South Africa: A Qualitative Study, Ingrid T. Katz, Janan Dietrich, Gugu Tshabalala, Thandekile Essien, Kathryn Rough, Alexi A. Wright, David Bangsberg, Glenda E. Gray, Norma C. Ware

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV treatment initiatives have focused on increasing access to antiretroviral therapy (ART). There is growing evidence, however, that treatment availability alone is insufficient to stop the epidemic. In South Africa, only one third of individuals living with HIV are actually on treatment. Treatment refusal has been identified as a phenomenon among people who are asymptomatic, however, factors driving refusal remain poorly understood. We interviewed 50 purposively sampled participants who presented for voluntary counseling and testing in Soweto to elicit a broad range of detailed perspectives on ART refusal. We then integrated our core findings into an explanatory framework. Participants described …