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.
Volume (Year): 68 (2009)
Issue (Month): 12 (June)
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- Susan Cotts Watkins, 2004. "Navigating the AIDS Epidemic in Rural Malawi," Population and Development Review, The Population Council, Inc., vol. 30(4), pages 673-705.
- Kakoko, Deodatus Conatus & Åstrøm, A.N. & Lugoe, Wycliffe L. & Lie, Gro T., 2006. "Predicting intended use of voluntary HIV counselling and testing services among Tanzanian teachers using the theory of planned behaviour," Social Science & Medicine, Elsevier, vol. 63(4), pages 991-999, August.
- Rebecca L. Thornton, 2008. "The Demand for, and Impact of, Learning HIV Status," American Economic Review, American Economic Association, vol. 98(5), pages 1829-1863, December.
- Beardsell, Susan & Coyle, Adrian, 1996. "A review of research on the nature and quality of HIV testing services: A proposal for process-based studies," Social Science & Medicine, Elsevier, vol. 42(5), pages 733-743, March.
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