“normalization” of appearance with ART use makes it far more difficult to
“normalization” of appearance with ART use makes it more hard to know persons that are infected. Though it was unclear how robust of an influence such perceived neighborhood opinions had around the men and women who had declined initiation of ART, this phenomenon was largely raised as a hypothetical barrier by those that had initiated ART. “I have heard men and women complaining that these drugs have made it difficult to know who is optimistic and who is not. Ahead of they had been introduced, the HIVAIDS symptoms alone could have aroused some suspicions. These drugs somehow cover these symptoms generating it tough to know who’s HIV positive and who is not. There’s also the worry that such sufferers who have benefited from these drugs can very easily infect others.” (HIVinfected female, 32 years, initiated ART, companion declined PrEP) Apart from common perceived opposition to ART initiation from neighborhood members, some participants, mostly female, specifically stated that some religious groups or belief systems discouraged the use of ART. These groups think that HIV would be 
the outcome of witchcraft or wrongdoing, as well as the groups’ leaders or believers deter HIVinfected folks fromPLOS 1 DOI:0.37journal.pone.068057 December 8,6 Facilitators and Barriers of ART Initiationinitiating ART. Alternatively, they advise the HIVinfected people to try alternative medicines or depend on god’s mercy to remedy them. “[My mum] associates [serodiscordancy] with satanic forces since she can not realize the concept of discordant couples along with the causes. She believes HIV is often a disease triggered by Satan.” PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/25624429 (HIVinfected female, 34 years, initiated ART, companion on PrEP) “I was informed by somebody that a number of them (HIVinfected men and women) get discouraged by some churches or religions that think that god can save and remedy somebody from this HIV. So some of them (HIVinfected folks) don’t see any purpose as to why they need to take the drugs when an simpler alternative (like praying) is obtainable.” (HIVinfected female, 35 years, initiated ART, companion on PrEP) “There are individuals who also strongly think within the religious beliefs. You will discover some religions that MedChemExpress LOXO-101 (sulfate) usually do not allow their followers to utilize western medication. Thus, some of them will decline using the pills since they usually do not want to go against their religious beliefs. . .it is all about faith. They believe that in case you have faith in God then you should really not use the medicines since it is God who heals the sick.” (HIVuninfected female, 45 years, declined PrEP, partner on ART) “Some religions and churches discourage against taking the drugs. Such churches could advocate for prayers as the only treatment a single should really seek. . .Then there are actually people that choose herbal medication towards the western medicine.” (HIVuninfected female, 36 years, initiated PrEP, companion on ART) Denial about HIV optimistic diagnosis: The majority of male and female participants who initiated or declined ART felt that one of the major factors for declining ART initiation was resulting from denial in regards to the HIV diagnosis. Participants also felt that social stigma surrounding HIV, in turn, fuels this denial. “When a lot of people have realized that they’re HIVinfected, they don’t desire to commence using these [ART] drugs mainly because they do not wish to accept that they’re infected. From time to time they say that if they visit the hospital, the will probably be observed by other people today who know them.” (HIVinfected female, 23 years, declined ART, companion on PrEP) “Sometimes an individual may perhaps believe that she isn’t HIV in.
