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Asking God about the date you will die: HIV testing as a zone of uncertainty in rural Malawi


  • Amy Kaler

    (University of Alberta)

  • Susan Watkins

    (University of Pennsylvania)


Testing for HIV is becoming more available in Africa. Global advocates of testing see it as key to AIDS prevention. However, testing is not always perceived as a good thing by people at risk. Here, we consider testing from the perspective of people in a high-prevalence community. Using qualitative data from rural Malawi, we show that the decision to test is not as straightforward as suggested in the testing advocacy literature, but is marked by uncertainty and ambivalence. Reluctance to test is connected to the perception that testing inevitably leads to a positive diagnosis, and subsequent deterioration and death. This fear is in turn linked to overestimation of the transmissibility of HIV. We recommend that testing advocates address this concern that being tested means having a death sentence pronounced, and emphasize the benefits of testing for the majority who are HIV-negative, as well as the minority who are HIV-positive.

Suggested Citation

  • Amy Kaler & Susan Watkins, 2010. "Asking God about the date you will die: HIV testing as a zone of uncertainty in rural Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 23(32), pages 905-932, November.
  • Handle: RePEc:dem:demres:v:23:y:2010:i:32

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    Cited by:

    1. Wilson, Nicholas, 2016. "Antiretroviral therapy and demand for HIV testing: Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 21(C), pages 221-240.
    2. repec:dem:demres:v:37:y:2017:i:42 is not listed on IDEAS
    3. Angotti, Nicole, 2010. "Working outside of the box: How HIV counselors in Sub-Saharan Africa adapt Western HIV testing norms," Social Science & Medicine, Elsevier, vol. 71(5), pages 986-993, September.
    4. Nicole Angotti & Margaret Frye & Amy Kaler & Michelle Poulin & Susan Cotts Watkins & Sara Yeatman, 2014. "Popular Moralities and Institutional Rationalities in Malawi's Struggle Against AIDS," Population and Development Review, The Population Council, Inc., vol. 40(3), pages 447-473, September.

    More about this item


    ambivalence; HIV/AIDS testing; Malawi;

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General


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