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

5.3 Social Relations and HIV Testing
Although our findings show that some people made the decision to take an HIV
test individually without consulting others, others discussed the decision to take an HIV
test with people who might have had an interest in their taking an HIV test. For example,
about 26 percent of those who had just taken an HIV test (Dar es Salaam and Iringa
respondents combined) reported they discussed it with their spouse, 14 percent with their
mother, 23 percent with their sister, and 14 percent with their brother. Although men
were more likely to discuss it with their brother than their mother, women were more
likely to discuss taking an HIV test with their mother as well as their sister. On the other
hand, a higher proportion of men than women discussed the decision with their spouse:
32 percent versus 23 percent. Most respondents also reported discussing the kind of
health problems they were experiencing with their relatives and friends. Some even told
us that they discussed their specific situations with their friends or relatives, situations
such as the death of a spouse or sexual partner from a mysterious illness. It is through
these discussions that relatives or friends provided a variety of advice, including the
importance of knowing their serostatus. According to some respondents, particularly
women, some of the people with whom they had discussed their health problems had
apparently advised them to take an HIV test, and also accompanied them to a VCT
facility. Some respondents felt comfortable discussing their interest of taking an HIV test
with people who they thought shared a similar situation or fate.
Finally, it is important to consider the situation of individuals who get tested
routinely, cases where a health care provider has initiated the idea of testing (i.e. provider
initiated), diagnostic HIV testing, and mandatory testing. In routine testing, HIV testing is
offered as a part of the clinical evaluation of all patients in settings where HIV is
prevalent. In this situation, those who agree to take an HIV test might not have the chance
to discuss it with their relatives or friends. As indicated in Chapter Four, Temeke
Hospital in Dar es Salaam is the only hospital we visited where routine testing
particularly for TB patients is taking place. At this health facility only five respondents
were interviewed. This type of HIV testing, more than others, links the infected patients
with preventive care measures. The advantages of HIV routine testing are that it might
eventually destigmatize the HIV testing process because many people do not perceive
themselves to be at risk or do not disclose risks, and it facilitates the acceptance of HIV
testing by offering it to everyone.
5.4 Benefits of VCT
This study also solicited comments on respondents’ experiences with VCT
services in their respective areas. The large majority of respondents were satisfied with
the VCT services received, and only a few indicated they were not satisfied. Those not
satisfied with VCT claimed that VCT services either needed some improvement, the
procedures were difficult to follow, or health workers were not caring towards the clients.
Because counselling and testing are processes that take place together, we shall discuss in
greater length the respondents’ experience of counselling and testing in the next chapter.
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