title: Perceptions of door-to-door HIV counselling and testing in Botswana.
abstract: Prevalence of HIV infection in Botswana is among the highest in the world, at 23.9% of 15 - 49-year-olds. Most HIV testing is conducted in voluntary counselling and testing centres or medical settings. Improved access to testing is urgently needed. This qualitative study assessed and documented community perceptions about the concept of door-to-door HIV counselling and rapid testing in two of the highest-prevalence districts of Botswana.   Community members associated many positive benefits with home-based, door-to-door HIV testing, including convenience, confidentiality, capacity to increase the number of people tested, and opportunities to increase knowledge of HIV transmission, prevention and care through provision of correct information to households. Community members also saw the intervention as increasing opportunities to engage and influence family members and to role model positive behaviours. Participants also perceived social risks and dangers associated with home-based testing including the potential for conflict, coercion, stigma, and psychological distress within households. Community members emphasised the need for individual and community preparation, including procedures to protect confidentiality, provisions for psychological and social support, and links to appropriate services for HIV-positive persons.
authors.affiliation: Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention-NCHHSTP, US Centers for Disease Control and Prevention-CDC, USA. knk2@cdc.gov
authors.forename: Karen
authors.initials: K
authors.lastname: Kroeger
authors.forename: Allan W
authors.initials: AW
authors.lastname: Taylor
authors.forename: Heather M
authors.initials: HM
authors.lastname: Marlow
authors.forename: Douglas T
authors.initials: DT
authors.lastname: Fleming
authors.forename: Vanessa
authors.initials: V
authors.lastname: Beyleveld
authors.forename: Mary Grace
authors.initials: MG
authors.lastname: Alwano
authors.forename: Mabel Tebogo
authors.initials: MT
authors.lastname: Kejelepula
authors.forename: Kentsenao Busang
authors.initials: KB
authors.lastname: Chilume
authors.forename: Dawn K
authors.initials: DK
authors.lastname: Smith
authors.forename: Thierry
authors.initials: T
authors.lastname: Roels
authors.forename: Peter
authors.initials: P
authors.lastname: Kilmarx
mesh_terms: D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001902:Botswana; D003219:Confidentiality; D037001:Directive Counseling; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology; D006297:Health Services Accessibility; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010465:Perception; D018570:Risk Assessment; D012944:Social Support; D055815:Young Adult