Uptake of HIV testing and treatment in an isolated population with access to free and universal healthcare

This Western Australian study analysed clinical information from 344 people with AIDS, and experiential data from a sample of 36 people with AIDS to investigate 2 relevant issues: the timing of HIV testing and uptake and experiences of HIV drug treatment. We found that the proportion of people presenting with AIDS before being diagnosed with HIV infection ('AIDS-presenters') fell from 47% in 1985-1987 to 20% in 1991-1993. Since antiretroviral therapy (ART) became available in 1987, two-thirds of Western Australian people with AIDS who knew of their HIV infection prior to the development of AIDS have consistently elected to take recommended HIV treatment. Four phases of the treatment experience were identified. It is concluded that 'AIDS-presentation' is unlikely to reduce further and that the timing of testing and issues of treatment acceptance are only understood when the experiences of people with illness are examined using a patient-centred approach.