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

Many people are increasingly willing to take an HIV test because they
want to access medicine, but such delays tend to discourage people and
others lose hope. I have also noted that some health care providers tend to
use harsh and foul language. I suggest that they should be friendly to
patients.
Another 40-year-old male from Iringa said the following expressed his concern
about the VCT and CTC services:
Sometimes you may visit the clinic when the date of your appointment
collides with the day for children’s clinic. In some cases the service
providers become so unfriendly and harsh and they usually decline to help
you. Most patients become so embarrassed with this situation.
Another challenge confronting people in connection with counselling and testing
is the distance they have to travel to access the service. Most of our respondents visited
the VCT centre after having experienced frequent illnesses and their health condition had
already started to deteriorate. They indicated that some of them lived in the rural areas
and were forced to travel to urban areas to access such services. For people who were
poor, this was indeed a barrier for accessing both VCT and CTC services.
Another major challenge that confronts Tanzania’s VCT process is the ongoing
problem of the situation of stigmatized stand-alone VCT facilities. For example, the
Angaza centres are stand-alone centres. Although the CTC services are attached to most
hospitals, such services are accommodated in special buildings that are easily labelled as
buildings for people with HIV/AIDS. For example the CTC at Iringa Regional Hospital
has been built and is hidden behind the outpatient wing of the regional hospital.
Information derived from health care providers as well as some respondents indicated
that most people labelled that building as “Nyumba ya Kliniki ya Watu Wenye Ukimwi,”
meaning “the building that houses the clinic of people who have HIV/AIDS.” In a
country like Tanzania where stigma against HIV/AIDS is still high, isolating VCT
services from other health services tends to stigmatize these services and this can
function as a barrier for people wanting to opt for HIV tests but do not want other people
to know.
6.8 Conclusion
This chapter has described the structure of the counselling process as experienced
by our respondents, and the content of what they were told during the pretest and posttest
counselling sessions. Respondents reported on their contacts with counsellors in very
positive terms, often saying how useful they found the advice offered. A certain number
also sought advice from religious leaders to support them. Although the majority of
respondents’ attitudes towards the process of counselling and testing was positive, and
there were clear benefits to both counselling and testing, the findings showed that some
people were critical of the services provided at various VCT centres. The findings also
showed that there are many problems and challenges associated with the experience of
VCT processes in Tanzania that need to be addressed to bring about improvement in the
services offered by VCT facilities.
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