{
  "abstract": "Introduction\n\nUniversal Test and Treat (UTT) was introduced to South Africa in 2016 as an HIV prevention and treatment strategy. In this study we aimed to assess the individual perspectives of people living with HIV (PLWH) on starting antiretroviral therapy (ART) during the early implementation of UTT.Methods\n\nWe conducted a thematic analysis of transcripts from interviews with PLWH who had initiated ART and were enrolled in a randomized controlled trial of point-of-care viral load testing in Durban, South Africa.Results\n\nTwenty-five interviews were conducted between March - August 2018,16 (64%) female, 9 (36%) male PLWH, a median age of 30 years. Asymptomatic participants reported needing time to accept their diagnosis and sought shared decision-making discussions with healthcare-providers about starting treatment. Others appreciated the healthcare-provider leading the decision to treatment, which helped them cope with the shock of testing positive. Many participants indicated being happy with starting treatment early as this meant living a normal life and prevented sickness or death. Some saw UTT as an indication that the public healthcare-system cared for them. For those who tested before UTT implementation, some expressed frustrations about being denied treatment due to high CD4 counts. Policymakers had concerns about stigma being a barrier to UTT and adherence, some participants reported that disclosing their status enabled social support which encouraged adherence.Conclusions\n\nThe implementation of UTT in South Africa has provided a supportive framework for people to understand their diagnosis, accept it and adhere to ART in a caring space.",
  "abstract_shown": true,
  "affiliations": [
    "Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.",
    "Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.",
    "Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.",
    "Department of Psychology, University of Exeter, Exeter, UK.",
    "eThekwini Municipality Health Department, Durban, South Africa.",
    "Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, USA.",
    "Department of Medicine, School of Medicine, University of Washington, Seattle, USA.",
    "Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA.",
    "Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.",
    "Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa. jienchi.dorward@phc.ox.ac.uk.",
    "Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. jienchi.dorward@phc.ox.ac.uk."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Upasna Singh",
      "orcid": "0000-0002-7453-3489"
    },
    {
      "affs": [
        0
      ],
      "name": "Lindani Msimango"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Andrew Gibbs"
    },
    {
      "affs": [
        0
      ],
      "name": "Hlengiwe Shozi"
    },
    {
      "affs": [
        0
      ],
      "name": "Farzana Osman"
    },
    {
      "affs": [
        4
      ],
      "name": "Yukteshwar Sookrajh"
    },
    {
      "affs": [
        5,
        6,
        7
      ],
      "name": "Paul K Drain"
    },
    {
      "affs": [
        0,
        8
      ],
      "name": "Nigel Garrett"
    },
    {
      "affs": [
        9,
        10
      ],
      "name": "Jienchi Dorward"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/00x0xs5g44n8f.bib",
  "cited_by": 0,
  "doi": "10.1186/s12889-026-28876-y",
  "fulltext_url": "https://europepmc.org/articles/PMC13729519",
  "id": "00x0xs5g44n8f",
  "issns": [
    "1471-2458"
  ],
  "landing_url": "https://europepmc.org/article/MED/42972528",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2725|HIV/AIDS Research and Interventions"
    ]
  ],
  "openalex": "W7172534196",
  "pdf_url": "https://europepmc.org/articles/PMC13729519?pdf=render",
  "pmcid": "PMC13729519",
  "pmid": "42972528",
  "published": "2026-08-06",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/00x0xs5g44n8f.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:44Z",
      "native_id": "MED:42972528",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42972528"
    },
    {
      "first_seen": "2026-11-07T12:22:15Z",
      "native_id": "PMC13729519",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12889-026-28876-y"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|HIV/AIDS Research and Interventions",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Patients' perceptions on HIV testing and starting antiretroviral therapy during implementation of universal test and treat.",
  "title_text": "Patients' perceptions on HIV testing and starting antiretroviral therapy during implementation of universal test and treat.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:15Z",
  "url": "https://research.draconitic.com/paper/00x0xs5g44n8f",
  "venue": "BMC public health",
  "versions": []
}