title: Women's barriers to HIV-1 testing and disclosure: challenges for HIV-1 voluntary counselling and testing.
abstract: In view of the ever-increasing HIV/AIDS epidemic in sub-Saharan Africa, the expansion of HIV-1 voluntary counselling and testing (VCT) as an integral part of prevention strategies and medical research is both a reality and an urgent need. As the availability of HIV-1 VCT grows two limitations need to be addressed, namely: low rates of HIV-1 serostatus disclosure to sexual partners and negative outcomes of serostatus disclosure. Results from a study among men, women and couples at an HIV-1 VCT clinic in Dar es Salaam, Tanzania are presented. The individual, relational and environmental factors that influence the decision to test for HIV-1 and to share test results with partners are described. The most salient barriers to HIV-1 testing and serostatus disclosure described by women include fear of partners' reaction, decision-making and communication patterns between partners, and partners' attitudes towards HIV-1 testing. Perception of personal risk for HIV-1 is the major factor driving women to overcome barriers to HIV-1 testing. The implications of findings for the promotion of HIV-1 VCT programmes, the implementation of partner notification policies and the development of post-test support services are discussed.
authors.affiliation: Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA.
authors.forename: S
authors.initials: S
authors.lastname: Maman
authors.forename: J
authors.initials: J
authors.lastname: Mbwambo
authors.forename: N M
authors.initials: NM
authors.lastname: Hogan
authors.forename: G P
authors.initials: GP
authors.lastname: Kilonzo
authors.forename: M
authors.initials: M
authors.lastname: Sweat
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology* / Q000628:therapy; D015528:HIV Seroprevalence; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology*; D011795:Surveys and Questionnaires; D014342:Truth Disclosure