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

Patients now wait for equipment or reagents to be delivered to perform tests necessary to
begin taking ARVs.
Another challenge confronting people wanting to test is the distance they have to
travel to access the service. Most of our respondents travelled far to a VCT centre.
Another major challenge of VCT is that the use of a stand-alone facility may be
stigmatized. Although CTC services are attached to most hospitals, we noted that such
services are accommodated in special buildings that are easily identifiable by people as
buildings for people with 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.
8.5 Implications of Study Findings to VCT Services in Tanzania
The findings of this study help us to understand the nature of social relations that
surround and influence not only processes of counselling and testing for HIV/AIDS, but
also the process of disclosing HIV test results to others. For example, the findings show
that:
• It is important to recognize that individuals live in a social context that influences
the way they perceive risks, the way they make decisions about HIV testing, and
finally whether to disclose their test results to others or not. Understanding this
reality can assist counsellors in considering the individual circumstances of their
clients and tailor their advice to fit the needs and problems that clients experience.
• It is important to treat post-test counselling not as the end process of VCT
services, but as an introduction to a system of support. This is only possible if
ways of maintaining future contacts between VCT service providers and clients
are put in place. Although the national guidelines for VCT encourage follow-up
counselling after posttest counselling shows HIV test results, this study did not
collect findings about whether this takes place in practice.
• Disclosure is not a simple matter of individuals telling one or two persons they are
HIV positive or negative. Rather, the person who hears the news must also accept
and believe that news and may need help in dealing with the implications. What
this means is that most VCT clients need further assistance to negotiate the news
of their serostatus.
8.6 Recommendations
The observations and findings from this study suggest the following points of
emphasis and policy recommendations:
• The amount of time and money needed to obtain an HIV test constitutes a barrier
to VCT services. It is assumed that if VCT services are more accessible, more
people will use the services. Therefore, there is a need to facilitate access to VCT
services for the public, particularly in rural areas.
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