"The anticipation alone could kill you": past and potential clients' perspectives on HIV testing in non-health care settings.
HIV testing in non-health care settings is an effective strategy for increasing the proportion of persons aware of their infection. We conducted 21 focus groups with 186 past and potential clients in five U.S. cities to explore attitudes and experiences related to HIV counseling and testing in non-health care settings. Qualitative analysis yielded several key themes. HIV-related stigma and fear emerged as a main theme throughout the discussions. Knowing one's HIV status quickly and accurately was of primary importance; HIV prevention counseling was secondary. Participants prioritized a supportive, nonjudgmental environment with adequate privacy and confidentiality. Provision of immediate emotional support, medical information, and linkage services to HIV-infected clients were considered essential. Staff with HIV-specific skills to address clients' emotional and informational needs was considered a strength of non-health care testing programs. Frequently, however, participants compared non-health care settings unfavorably to health care settings regarding privacy, competency, confidentiality, and test accuracy. Recommendations for enhancing counseling and testing services in non-health care settings are discussed.
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. HJoseph1@cdc.gov
Heather A
HA
Joseph
Amy M
AM
Fasula
Rebecca L
RL
Morgan
Amy
A
Stuckey
Maria E
ME
Alvarez
Andrew
A
Margolis
Dale
D
Stratford
Samuel W
SW
Dooley
D015492:AIDS Serodiagnosis; D000293:Adolescent; D001007:Anxiety / Q000523:psychology*; D003151:Community Health Centers / Q000458:organization & administration; D003376:Counseling; D005239:Fear; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology*; D006679:HIV Seropositivity / Q000175:diagnosis / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D036301:Qualitative Research; D057545:Social Stigma; D055815:Young Adult