Objectives We aimed to explore the experiences of people who initiated rapid antiretroviral therapy (ART) within 7 days of HIV diagnosis, as part of routine care in London.
Methods Using purposive sampling, 18 in-depth, semistructured interviews were conducted between December 2020 and September 2021 with people who started rapid ART at Barts Health NHS Trust. Participants aged 22–69 years included 15 cisgender men and three cisgender women. Five identified as heterosexual and 13 as gay and bisexual and other men who have sex with men. Ethnic identities: six White Non-UK, five White UK, three Black Caribbean, two South Asian and two East Asian. Interviews explored feelings about the new HIV diagnosis, attitudes to rapid ART including barriers to and facilitators of starting. Thematic analysis of transcribed interviews was undertaken.
Results Four themes were identified: (1) being offered rapid ART is acceptable; (2) it is a way of taking control of their health; (3) the need for information and support and (4) an individualised approach to care. Reasons for starting included getting well, staying well and reducing the likelihood of passing on HIV. Facilitators included being given comprehensive information about treatment and managing potential side-effects and a supportive clinical team. Support specified included a non-judgemental attitude, approachability, reassurance, encouragement and information about peer support. Most participants expressed they could not understand why people would not begin treatment, but suggested needing more time to decide and denial of diagnosis as possible barriers.
Conclusions To our knowledge, this is the first qualitative study exploring the experiences of people initiating rapid ART in the UK. It was deemed acceptable to an ethnically diverse, predominantly male sample of people newly diagnosed with HIV. Future research should include strategies to recruit a more gender diverse sample and those who declined or stopped rapid ART.
- Anti-Retroviral Agents
- QUALITATIVE RESEARCH
Data availability statement
Data are available on reasonable request. Data are available on reasonable request and with all potentially identifiable individual data removed.
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Handling editor Miłosz Parczewski
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Contributors RD and KD are responsible for the overall content as guarantors. RD designed the study, carried out and analysed the interviews and drafted and revised the manuscript. AM reviewed the study design, carried out and analysed the interviews and reviewed the manuscript. JPT reviewed the study design, advised on the running of the study and reviewed the manuscript. LK reviewed the study design, advised on the running of the study and reviewed the manuscript. NM reviewed the study design and the manuscript. CO reviewed the study design and the manuscript. KD designed the study, supervised the research and drafted and revised the manuscript.
Funding This work was supported by the British HIV Association grant number 5020.
Competing interests RD has received grants from the British HIV Association and speaking honoraria from Gilead and ViiV. JT has received grants from the British HIV Association and Gilead and speaking honoraria from Gilead. NM has received support from ViiV for conference registration fees. CO has received grants from ViiV, Gilead, MSD, GSK and Astra Zeneca and speaking honoraria from Gilead, ViiV and MSD. CO is Chair of the Medical Women’s Federation.
Provenance and peer review Not commissioned; externally peer reviewed.
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