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

usually insisted on getting the testing consent from the client himself/herself. The case of
a 40-year-old woman who was accompanied to a VCT centre by her sister and brother-inlaw
serves as an example. After reaching the VCT centre, the relatives asked a counsellor
to test the woman in question. The following shows how the conversation began.
Counsellor: Your relatives want you to have an HIV test. Do you agree?
Client: Yes, I do.
Counsellor: Although your relatives are around and are aware of your
decision to have an HIV test, our ethics of counselling
require that I counsel you alone and that I will share the
results of the test with you alone. However, you can share
the results with your relatives if you wish to do so. But I,
as a counsellor, cannot disclose the results to another
person. All that you and I discuss will be confidential.
As this conversation shows, the counsellor was concerned with not only informed
consent, but also with confidentiality. The counsellor explained to the client that although
she was escorted by relatives and that the relatives asked on her behalf for counselling
and testing, the counselling process was going to be confidential and the relatives would
not be allowed to participate. The counsellor also informed the client that the information
about the result of her test would be released to no one else except to her.
6.4.2 Information on HIV/AIDS, HIV Transmission, and Risk Behaviour
Although almost all respondents already knew about HIV/AIDS and how it is
transmitted before they visited the HIV testing facility, as shown in Chapter Five, the
respondents told us that their counsellors explained again to them what HIV was, how it
was transmitted, the distinction between HIV and AIDS, and the kind of risky behaviours
that facilitated HIV transmission. Some clients acknowledged the fact that they learned
new information about HIV during these counselling sessions. A quote from one 40-yearold
respondent illustrates this:
Before visiting the VCT centre, I knew very little about HIV/AIDS and HIV
transmission. Now I know a lot, I am going to disseminate the knowledge
that I gained from these counselling sessions to both my relatives and
friends.
6.4.3 Assessment of Possibilities of Exposure to HIV Infection
Respondents also said that the counsellors asked them questions to ascertain
whether they had been involved in risky behaviour that might have exposed them to HIV
infection. According to both counsellors and respondents, such a discussion prepared the
clients/respondents for the outcome of their test results. For example, for those who
might have been involved in risky behaviours, a discussion aimed at assessing the
possibilities of exposure to HIV infection prepared the clients for the worst results. The
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