Delayed pursuit of health care among HIV-positive gay men enrolled in a longitudinal research study.

The aim of this qualitative article is to describe the reasons HIV-positive gay men who are enrolled in a longitudinal research project give for not initiating health care. Extreme sampling techniques were used to recruit four HIV-positive gay men who are enrolled in a research project that is examining factors related to disease progression in HIV infection but who do not otherwise receive any health care. Intensive, open-ended interviews were conducted, and the interviews were analyzed for recurring themes. Results indicate that the participants did not have an accurate perception of health care and therefore were hesitant in seeking health care. Part of this hesitation involved their strong reluctance to begin antiretroviral therapy. Enrollment in a longitudinal study allowed the participants to have some monitoring of their HIV infection. However, not having a primary care provider resulted in a lack of preparedness when they encountered changes in their health status. The end result of this process was progression in their HIV disease. Implications for clinicians and researchers are discussed.