Women's barriers to HIV-1 testing and disclosure: challenges for HIV-1 voluntary counselling and testing

AIDS Care. 2001 Oct;13(5):595-603. doi: 10.1080/09540120120063223.


In view of the ever-increasing HIV/AIDS epidemic in sub-Saharan Africa, the expansion of HIV-1 voluntary counselling and testing (VCT) as an integral part of prevention strategies and medical research is both a reality and an urgent need. As the availability of HIV-1 VCT grows two limitations need to be addressed, namely: low rates of HIV-1 serostatus disclosure to sexual partners and negative outcomes of serostatus disclosure. Results from a study among men, women and couples at an HIV-1 VCT clinic in Dar es Salaam, Tanzania are presented. The individual, relational and environmental factors that influence the decision to test for HIV-1 and to share test results with partners are described. The most salient barriers to HIV-1 testing and serostatus disclosure described by women include fear of partners' reaction, decision-making and communication patterns between partners, and partners' attitudes towards HIV-1 testing. Perception of personal risk for HIV-1 is the major factor driving women to overcome barriers to HIV-1 testing. The implications of findings for the promotion of HIV-1 VCT programmes, the implementation of partner notification policies and the development of post-test support services are discussed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Counseling
  • Female
  • HIV Infections / prevention & control
  • HIV Infections / psychology*
  • HIV Infections / therapy
  • HIV Seroprevalence
  • Humans
  • Male
  • Patient Acceptance of Health Care / psychology*
  • Sexual Partners / psychology*
  • Surveys and Questionnaires
  • Truth Disclosure