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

7.1 Introduction
7. DISCLOSURE AND SOCIAL RELATIONS IN TANZANIA
It is increasingly recognized that VCT can play a critical role in the prevention of
HIV/AIDS. However, this can only become an effective strategy if those who take an
HIV test disclose the outcome of their test results to others. Although getting people to
take an HIV test is one thing, and an important step in its own right, disclosing the
outcome of the test results to significant others, and sexual partners in particular, is
another thing. Without disclosure, these significant others will not be able to know
whether their friends, relatives, or sexual partners are infected with HIV or not. To sexual
partners, the lack of knowledge of the serostatus of the sexual partner puts them at risk of
contracting HIV themselves.
Most of our respondents considered disclosure as an important action that
followed voluntary counselling and testing for HIV. The findings indicate that the
respondents disclosed their HIV status selectively and voluntarily. The major
circumstances that led them to take an HIV test were: frequent illness, observed
experience from a partner (in case of illness or/and death), a family situation, and advice
from another party. Our findings strongly suggest that motivation for disclosure varied
according to the type of relationships in which the individual was involved. For example,
mutual obligation seemed to be an underlying factor in disclosing to a family member
and/or partner. Although some respondents discussed taking an HIV test with their close
relatives, and others made those decisions without involving anyone, when it came time
to disclose, social relations played a very important role in determining who was told and
not told about the outcome of the test results.
7.2 Collecting Data on Disclosure
Collecting data on disclosure and eventually measuring and evaluating it is a
complex process. According to Nsabagasani and Yoder (2006), disclosure may be
voluntary or involuntary, direct or indirect, full or not full at all. Most studies of
disclosure have examined disclosure that is voluntary and direct, that is, situations in
which an individual voluntarily tells someone else directly of his or her serostatus.
“Delayed disclosure” is when disclosure was done after having sexual relations. Finally,
there are those who do not disclose at all (Nsabagasani and Yoder, 2006).
This study focused on the patterns of voluntary and direct disclosure. The
following main research questions guided this study: What are the factors and
circumstances that compelled people to take an HIV test? How do people disclose or not
disclose the results of their HIV test to significant others over time? Were the factors
involved in that process mainly individual characteristics that push an individual towards
disclosure, or were they primarily aspects of the social relations maintained by
individuals?
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