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

About a third of the respondents disclosed to their mothers, but there was a slight
difference by sex: 37 percent of women spoke to their mother, and 30 percent of men did
so. These findings show that there is a gender dimension in the pattern of disclosure for
the longer as well as the shorter term. More than half of the female respondents
(56 percent) disclosed their test results to their sisters and only 11 percent to their
brothers. On the other hand, about 33 percent of the male respondents disclosed their
results to their brothers. Only 24 percent of the male respondents disclosed their results to
their sisters. Overall, about 32 percent of the respondents disclosed their results to their
children. Female respondents were more likely to disclose to their children than male
respondents (44 percent vs. 21 percent) suggesting that mothers in Tanzania were more
likely to be closer to their children than fathers. This assumption is likely to be true
because women in Tanzania tend to be more prominent in the domestic sphere of life
(household) and men are more so in the public sphere of life.
Our findings show that most respondents disclosed their results to one of these
three blood relatives: a mother, sister, or brother. Apart from blood relatives, married
couples were inclined to discuss their results with their spouses, brothers, and sisters-inlaw,
followed by uncles, aunts, and friends. Very few single people with sex partners
disclosed their results to these partners. Generally, respondents did not find it easy to
discuss and disclose their results to fathers. This finding may reflect the fact that in
Tanzanian society, children find it easier to discuss personal issues that concern their
health with their mothers than with their fathers. It also reflects the traditional position
and role of women in Tanzanian society where women act as the caregivers in a situation
of health as well as in a situation of sickness. In this case, most people know that once
they become bed-ridden due to sickness, it will always be mothers, aunts, sisters, or any
other female relative that will assume the responsibility of taking care of them. The
response below from a 46-year-old married man illustrates individuals’ motives and
expectations of disclosing their results to specific persons:
I told my wife the same day that I got my test results because she supports
and nurses me. Not telling her would have hurt her, but I told my brother
after two days. He was surprised and asked where I got the disease from.
Another married, 30-year-old woman from Iringa responded by saying:
I told my mother and my sister the same day of getting my test results. My
young sister who is also positive accompanied me to the hospital where I
had to take a test. I told them because they are the ones who care for me.
You know, I have to eat well. I don’t like my neighbours to know that I am
positive, they will just point fingers at me and won’t give me any help.
As we have already mentioned, expectations such as possible social support tend
to influence the process of disclosure. Most of the respondents confirmed that obtaining
care was a major motivating factor in disclosing their results. For instance, a 47-year-old
man living with HIV/AIDS from Iringa explained this factor in the following way:
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