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There are well-established models of awareness by Prochaska et al. on behavioral research [4] that describe the stages of change: precontemplation, contemplation, preparation, action, and maintenance. We used a simplified version of the available models for HIV [5, 6] and presented this information in one table to help physicians, nurses, and patients.

For example, in ‘precontemplation’ a patient might say, ‘I will survive without treatment’, ‘I don’t need it, I feel good’, or ‘I don’t want to think about it’. But with lower CD4 T cells, he/she might contemplate treatment. It is most important to discuss data with a patient possibly changing the perception caused by wrong or insufficient information (www.europeanaidsclinicalsociety.org).

‘Preparation’ marks the stage when the patient says, ‘I want to start, I think the drugs will help me live a normal life’. Usually, this is the stage just before initiation of treatment. As stated above prognosis changed dramatically. From 2006 on it became obvious that the prognosis between HIV-positive patients and a HIV-negative normal population did not differ strongly anymore, at least in a large part [7]. However, survival still depends on individual factors such as illicit drug use, co-infections with the hepatitis viruses B and C or other conditions. The strongest individual factor for prognosis is associated again with behavior, i.e. adherence and continuous therapy [8, 9]. Many studies indicate that an insufficient level of drug intake has severe sequelae on resistance development, treatment effect and consequently survival.