social context of disclosing hiv test results: hiv testing in tanzania

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Researcher: Where did you take your HIV test? Respondent: I went to the Iringa Regional Hospital. Researcher: What made you take an HIV test? Respondent: I often suffered from high fever, and last October I was admitted at the hospital and got treatment for malaria… after being discharged, I still noted that I was tired all the time. I went back to the hospital and the doctor noted that I was coughing. Researcher: What did the doctor tell you? Respondent: He advised me to take an HIV test. Researcher: So the doctor is the one who advised you to get tested? Respondent: Yes, the doctor advised me to get tested after he saw that I had tuberculosis. Another respondent narrated her poor health as a motivating factor for seeking an HIV test in the following way: Case 3 Researcher: What made you take an HIV test? Respondent: The idea of testing my health was not from somebody else but I decided on my own because my husband died from a mysterious disease. He first suffered from tuberculosis, then became very weak and finally died… I went on with my normal life although something at the back of my mind kept on telling me that it might be AIDS that killed my husband. After waiting for a long time, I too started feeling bad and suffered from high fever. Sometimes I had malaria and in other times severe diarrhoea. I then decided that it was important for me to test my health. Researcher: Whom did you decide to tell that you are going to get tested, because you told me that your husband died? Respondent: I told my friend—a girl friend whose husband also died. We usually like discussing things among ourselves because the circumstances under which our husbands died were the same. After advising each other we decided to take an HIV test. My friend went first and tested positive. I then decided to test, too, and the results were positive. 34
Researcher: Is there anybody else who was not HIV positive whom you involved? Respondent: I did not involve anybody else before testing except my girl friend. Researcher: Why did you decide to do that? Respondent: I was afraid that they would stigmatize me because people stigmatize those who have this disease. Having this disease is a strange thing… a good example is my mother who started spreading rumours even before I got tested. Researcher: Your own biological mother? Respondent: Yes, she went around the streets telling people that they should look at me and see how I have lost weight. She assured them that it is because of the disease that is why I am withering away. Due to this, I decided to avoid all my relatives and friends. Although poor health brought many of the respondents in for an HIV test, it is not clear whether they wanted only to learn their serostatus and get explanations for their chronic illnesses, or if they also expected medical treatment, or both. Before the introduction of free ARVs in 2005 to Tanzania, one issue that was emphasized in HIV/AIDS campaigns was that AIDS had no treatment or cure. Therefore, for many people, seeking an HIV test was regarded as an act of requesting a death warrant if the results turned out to be positive. As a result, only a very few courageous people ventured to be tested, especially those who had suffered for a while from an illness. It was a way for them to confirm if they were infected with HIV or not, as we have seen above. However, with the introduction of free ARVs in 2005, a number of people who had chronic diseases started to opt for HIV testing to confirm if they had been infected with HIV; and if they had, they wanted to see whether they could be put on medication that could prolong their lives. One respondent echoed this view in the following way: When I realized that I was suffering from fever very frequently, and my health condition was deteriorating more and more, I decided to seek an HIV test so that if I am HIV positive, I can start taking ARVs and be able, therefore, to prolong my life. This group of respondents has shown that their situation of experiencing poor health and very frequent illnesses, such as recurring fevers or illnesses that never responded to treatment raised more questions than answers concerning their health situation. Therefore, their decision to take an HIV test is most likely motivated by the fact that they want to know the kind of illnesses they have, and whether such illnesses are AIDS related. Second, with the availability of ARVs it is very likely that they also want to take an HIV test so that if their illnesses are AIDS related, they can access care and treatment to prolong their lives. 35
Page 1: SOCIAL CONTEXT OF DISCLOSING HIV TE
Page 4 and 5: Cover photo: Iringa bus station (Jo
Page 6 and 7: 5.4 Benefits of VCT ...............
Page 9: ACKNOWLEDGEMENTS Many institutions
Page 13 and 14: Study Objectives EXECUTIVE SUMMARY
Page 15 and 16: HIV Counselling The respondents wer
Page 17: discrimination than are women. In a
Page 20 and 21: 1.2 Statement of the Problem It is
Page 22 and 23: 1.5 Significance of the Study The s
Page 24 and 25: Major Lakes HIV prevalance (THIS 20
Page 26 and 27: Stigma tends to affect men and wome
Page 28 and 29: The other challenge that VCT facili
Page 30 and 31: to their sexual partner or did not
Page 32 and 33: Disclosure to significant others ca
Page 34 and 35: and that encouraging disclosure onl
Page 37 and 38: 4. STUDY DESIGN AND METHODS OF DATA
Page 39 and 40: testing to side-step the stigma ass
Page 41 and 42: (b) Alamano Health Centre Alamano H
Page 43 and 44: Twenty-five of the respondents (44
Page 45 and 46: 4.6.1 Conversation Guide for Respon
Page 47: showing such information in confide
Page 50 and 51: 5.2 Conditions under Which People S
Page 54 and 55: 5.2.2 Respondents’ Other Reasons
Page 56 and 57: She, however, went to get tested as
Page 58 and 59: 5.3 Social Relations and HIV Testin
Page 61 and 62: 6.1 Introduction 6. COUNSELLING AND
Page 63 and 64: Many clients come to us with many r
Page 65 and 66: usually insisted on getting the tes
Page 67 and 68: There is no doubt that such a perso
Page 69 and 70: some respondents told us that those
Page 71 and 72: To understand the effects of ARVs o
Page 73 and 74: 7.1 Introduction 7. DISCLOSURE AND
Page 75 and 76: Respondent: People differ. Research
Page 77 and 78: Researcher: Do you have other reaso
Page 79 and 80: …eeh since I became sick, I had t
Page 81 and 82: Female respondents were often afrai
Page 83 and 84: lose the job as well as be chased a
Page 85 and 86: 7.6 Disclosure and HIV Prevention R
Page 87: however, that disclosure is limited
Page 90 and 91: 8.2 Respondents’ Views of Counsel
Page 92 and 93: Patients now wait for equipment or
Page 95 and 96: REFERENCES AMREF. 2008. Angaza HIV
Page 97 and 98: Klitzman, R.L., S.B. Kirshenbaum, B
Page 99: Skogmar, S., D. Shakely, M. Lans, J
Page 102 and 103:
Questions: What kind of work do you
Page 104 and 105:
Questions: What thoughts have you h
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social context of disclosing hiv test results: hiv testing in tanzania

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