{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:47Z","timestamp":1778803247985,"version":"3.51.4"},"reference-count":81,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T00:00:00Z","timestamp":1755302400000},"content-version":"vor","delay-in-days":1615,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>By the end of 2017, an estimated 83% of people living with HIV in Malaysia knew their serostatus. However, the Ministry of Health reported a high proportion of those newly diagnosed had low CD4 counts &amp;lt;200 cells\/\u00b5L, indicating late presentation for testing may be pervasive. Methods: A qualitative study was conducted to explore the context and experiences of people at risk of HIV infection testing and seeking treatment later in the course of their infection. Participants recruited (n = 20) were HIV positive, aged &amp;gt;18 years who fit the description of late presentation (World Health Organization defined as CD4 cell count &amp;lt;350 cells\/\u00b5L). Semi-structured interviews were conducted, and a framework approach was used to interrogate the data. Results: Many participants perceived themselves at low risk of HIV infection and did not undergo routine voluntary testing; rather, they were diagnosed when seeking treatment for serious illness or as part of mandatory employment-related testing. Perceived lack of confidentiality and potential discriminatory behaviour at public health facilities were significant deterrents to testing. Participants were satisfied with HIV treatment, but rarely sought psychosocial support in order to \u2018protect\u2019 their privacy. Conclusion: Unless drivers of HIV infection are effectively addressed, including stigmatising and discriminatory practices, and low health literacy, the occurrence of late presentation will persist. Their collective impact will not only jeopardise efforts to improve the treatment cascade, but may also impact engagement with other biomedical prevention and care technologies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh20180","type":"journal-article","created":{"date-parts":[[2021,3,14]],"date-time":"2021-03-14T21:48:50Z","timestamp":1615758530000},"page":"147-155","source":"Crossref","is-referenced-by-count":9,"title":["Delayed HIV testing and treatment seeking, and associated support needs among people living with HIV in Malaysia: a qualitative study"],"prefix":"10.1071","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9815-3683","authenticated-orcid":true,"given":"Susan C. S.","family":"Chong","sequence":"first","affiliation":[{"name":"ADepartment of Public Health, La Trobe University, Melbourne, Vic., Australia."},{"name":"BAustralian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic., Australia."},{"name":"FCorresponding author. Email: s.chong@latrobe.edu.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adeeba","family":"Kamarulzaman","sequence":"additional","affiliation":[{"name":"CFaculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia."},{"name":"DCentre of Excellence for Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iskandar","family":"Azwa","sequence":"additional","affiliation":[{"name":"CFaculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong-Xiang","family":"Ng","sequence":"additional","affiliation":[{"name":"CFaculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng-Li","family":"Chong","sequence":"additional","affiliation":[{"name":"DCentre of Excellence for Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nishaan","family":"Raman","sequence":"additional","affiliation":[{"name":"CFaculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Bourne","sequence":"additional","affiliation":[{"name":"BAustralian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic., Australia."},{"name":"EKirby Institute, University of New South Wales, Sydney, NSW, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2021,3,15]]},"reference":[{"key":"2025102615451506400_R1"},{"issue":"10","key":"2025102615451506400_R2","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.1097\/01.aids.0000233579.79714.8d","article-title":"Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA.","volume":"20","author":"Marks","year":"2006","journal-title":"AIDS"},{"issue":"1","key":"2025102615451506400_R3","doi-asserted-by":"publisher","first-page":"9","DOI":"10.3851\/IMP1523","article-title":"Medical and societal consequences of late presentation.","volume":"15","author":"Moreno","year":"2010","journal-title":"Antivir Ther"},{"issue":"4","key":"2025102615451506400_R4","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/j.jecm.2012.06.011","article-title":"Highly active antiretroviral therapy reduces mortality and morbidity in patients with AIDS in Sungai Buloh Hospital.","volume":"4","author":"Shah","year":"2012","journal-title":"J Exp Clin Med"},{"key":"2025102615451506400_R5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0005575","article-title":"Early antiretroviral therapy reduces AIDS progression\/death in individuals with acute opportunistic infections: a multicenter randomized strategy trial.","volume":"4","author":"Zolopa","year":"2009","journal-title":"PLoS One"},{"issue":"9","key":"2025102615451506400_R6","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1111\/j.1468-1293.2008.00613.x","article-title":"Cost of medical care for HIV-infected patients within a regional population from 1997 to 2006.","volume":"9","author":"Krentz","year":"2008","journal-title":"HIV Med"},{"key":"2025102615451506400_R7","doi-asserted-by":"publisher","first-page":"2145","DOI":"10.1097\/00002030-200411050-00006","article-title":"Late presenters in the era of highly active antiretroviral therapy: uptake of and responses to antiretroviral therapy.","volume":"18","author":"Sabin","year":"2004","journal-title":"AIDS"},{"key":"2025102615451506400_R8"},{"issue":"9635","key":"2025102615451506400_R9","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/S0140-6736(08)61113-7","article-title":"Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies.","volume":"372","author":"Antiretroviral Therapy Cohort Collaboration","year":"2008","journal-title":"Lancet"},{"key":"2025102615451506400_R10"},{"key":"2025102615451506400_R11","unstructured":"HIV\/STI\/Hepatitis C Section of Ministry of Health Malaysia. 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