PLHIV see huge benefits in treatment and know that eventually they will need to take ARVs. But in the Asia Pacific region there is some reluctance to start treatment earlier based purely on some practical issues. In starting they want to be assured there will be nothing that will threaten their long term treatment effectiveness related mainly to resistance and the need to rely on second-line regimens which are either not available or not affordable right now. People are also very aware of side effects and their fear of them causes a reluctance to take treatment until it is ‘really necessary’.
They do not believe that guidelines should be compromised by lack of financial and other resources and that the new guidelines should be based on ‘best practice’. If this seems at odds with the first statement, it is because they aspire to optimum treatment but live with the day-to-day practicalities of what is possible, even if it is not optimal
