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

5.5 Problems and Challenges of HIV Testing
Although HIV testing through VCT is becoming increasingly available in
Tanzania, many people are still reluctant to be tested, for they fear discrimination. As two
ladies said:
My mother started to inform other people that I was HIV positive even
before I was tested. She even told my children that their father who
recently died was HIV positive and that they should look somewhere else
when I die.
These findings are similar to findings that have been reported by other studies that
have shown that individuals avoid getting tested for fear of inappropriate HIV screening
without consent and counselling, fear of learning that one is HIV positive, fear of a
partner’s reaction, belief that one is unlikely to be exposed to HIV, and many others
(Fako, 2006; Campbell and Bernhardt, 2003; Burns et al., 2004; Isezuo and Onayemi,
2004; Peltzer et al., 2004; Gage and Ali, 2005). Because fear of rejection or stigma is a
common reason for avoiding testing, linking testing with ongoing care and support
services, as well as HIV education and awareness in the community, can reduce stigma
and may contribute to wider acceptance of VCT.
As far as challenges are concerned, there is a need to increase accessibility to
VCT, expand the buildings for VCT to promote privacy and maintain confidentiality,
increase awareness, and monitor the quality of counselling. Confidentiality and privacy
are the main fundamentals of counselling. Therefore, confidentiality must be strictly
observed as far as possible within the counselling setting, which may include cocounsellors
or assistants. The counselling should also be done in private. This calls for
expanding the buildings for VCT to promote privacy and maintain confidentiality. We
shall discuss more issues that relate to challenges and problems of VCT in the next
chapter.
5.6 Conclusion
In this chapter we have shown that there are many circumstances that compel
people to take an HIV test. By looking at the circumstances and reasons that made them
take an HIV test, we noted that these respondents fall into two distinct groups: those who
got tested because they were experiencing poor health, and those who got tested because
of other reasons. For those whose health condition was poor, respondents were seeking
explanations for their chronic illnesses and a hope of antiretroviral drugs that could
prolong their lives. Those who appeared healthy were motivated by their worries about a
family situation like death of a sexual partner, chronic illness of a sexual partner, or
concern of infidelity of a spouse or sexual partner. We have also argued that although
there are respondents who made decisions to get tested individually, many respondents
stated that they discussed the idea of testing with family members, relatives, neighbours,
or friends, and that they weighed many factors before deciding to get tested. What this
means is that HIV testing is not a technical process isolated from social factors, but it is
above all a social process. The process starts by an individual making the decision to be
tested or discussing his or her health problems or worries with other people, then he or
she accesses testing services, undergoes counselling, takes the test, and waits for the
results.
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