Abstract
BACKGROUND: AIDS is a global public health issue that requires continuous monitoring and response. Although antiretroviral therapy has decreased the death rate among people living with HIV, several physical and mental health issues remain to be addressed. Seeking help might be a way to solve mental health problems for people living with HIV. Although the research on help-seeking behavior is extensive, the specific content, process, and mechanism of help-seeking behavior in people living with HIV are still unclear. This study aims to explore the mechanism and process of help-seeking behavior in peolple living with HIV and to provide a reference for promoting such behavior. METHODS: From December 2024 to March 2025, 34 HIV/AIDS patients in Sichuan Province, China, were selected for face‒to-face semi-structured interviews, and the grounded theory method was used to analyse and integrate the data. RESULTS: The interviewees were 25-75 years old, 22 were male, 12 were female, and their education levels were mainly primary school or junior high school. The process and mechanism of help-seeking behavior among people living with HIV include four stages: identification of help-seeking problems; awakening of help-seeking awareness; development of help-seeking behavior; and maintenance of help-seeking interactions. CONCLUSIONS: The help-seeking behavior of people living with HIV is a dynamic process that can be conceptualized within Ajzen’s theory of planned behavior. This perspective underscores the need for healthcare providers to dynamically evaluate an individual's status across the key theory of planned behavior constructs (attitudes, subjective norms, and perceived behavioral control) throughout their journey. Interventions should then be strategically tailored on the basis of this assessment to effectively promote and sustain help-seeking behavior. TRIAL REGISTRATION: http://www.chictr.org.cn ChiCTR2400094174. Registered 18/12/2024, first recruitment 19/12/2024. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-26617-9.