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This study aimed to explore the decision\u2010making process of ART initiation in China. A phenomenological research design was used and semi\u2010structured, in\u2010depth interviews based on dual\u2010system theory were conducted. Participants were selected using purposive sampling between December 11, 2021 and June 25, 2022. Interpretative phenomenological analysis (IPA) was performed utilizing the software NVivo 12. A total of 34 PLHIV were interviewed. The heuristic system and the analytic system were involved in the complex decision\u2010making process for ART initiation. Acceptability, negative emotion, and stigma were all parts of the heuristic system. The analytic system included the perception of ART benefits, positive support, and misconception. Two systems interacted with each other in the decision\u2010making of ART initiation. PLHIV's initiation decision was determined by the components of the dominant system. This theory\u2010driven qualitative study provided valuable insights on the decision\u2010making process of ART initiation among newly diagnosed PLHIV.<\/jats:p>","DOI":"10.1111\/nhs.13169","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T04:51:11Z","timestamp":1730091071000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["\u201cNo Medication Means No <scp>HIV<\/scp> Diagnosis\u201d: A Qualitative Study Based on Dual\u2010System Theory on <scp>HIV<\/scp> Antiretroviral Therapy Initiation Decision\u2010Making"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2233-6838","authenticated-orcid":false,"given":"Yaqin","family":"Zhou","sequence":"first","affiliation":[{"name":"Xiangya School of Nursing Central South University  Changsha 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