Increasing the acceptability of HIV counseling and testing with three C's: convenience, confidentiality and credibility.
Agencies engaged in humanitarian efforts to prevent the further spread of HIV have emphasized the importance of voluntary counseling and testing (VCT), and most high-prevalence countries now have facilities that offer testing free of charge. The utilization of these services is disappointingly low, however, despite high numbers reporting that they would like to be tested. Explanations of this discrepancy typically rely on responses to hypothetical questions posed in terms of psychological or social barriers; often, the explanation is that people fear learning that they are infected with a disease that they understand to be fatal and stigmatizing. Yet when we offered door-to-door rapid blood testing for HIV as part of a longitudinal study in rural Malawi, the overwhelming majority agreed to be tested and to receive their results immediately. Thus, in this paper, we ask: why are more people not getting tested? Using an explanatory research design, we find that rural Malawians are responsive to door-to-door HIV testing for the following reasons: it is convenient, confidential, and the rapid blood test is credible. Our study suggests that attention to these factors in VCT strategies may mitigate the fear of HIV testing, and ultimately increase uptake in rural African settings.
University of Texas at Austin, TX, USA. nangotti@mail.utexas.edu
Nicole
N
Angotti
Agatha
A
Bula
Lauren
L
Gaydosh
Eitan Zeev
EZ
Kimchi
Rebecca L
RL
Thornton
Sara E
SE
Yeatman
D000293:Adolescent; D000328:Adult; D003219:Confidentiality; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006679:HIV Seropositivity / Q000175:diagnosis; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D008295:Malawi; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D035502:Trust; D055815:Young Adult