"It's better not to know": perceived barriers to HIV voluntary counseling and testing among sub-Saharan African migrants in Belgium

AIDS Educ Prev. 2009 Dec;21(6):582-93. doi: 10.1521/aeap.2009.21.6.582.


This study explored perceptions, needs, and barriers of sub-Saharan African migrants in relation to HIV voluntary counseling and testing (VCT). Using an inductive qualitative methodological approach, data were obtained from focus group discussions. Results showed that participants were in principle in favor of VCT. However, they indicated that barriers outweighed advantages. Such barriers included fear of positive test results and its related personal and social consequences, lack of information, lack of preventive health behavior, denial of HIV risk, and missed opportunities. Limited financial resources were only a concern for some subgroups like young people, asylum seekers, and recent migrants. This study identified multiple and intertwined barriers to VCT from a community perspective. In order to promote VCT, interventions such as raising awareness through culturally sensitive education should be adopted at community level. At level of service provision, provider initiated HIV testing including target group tailored counseling should be promoted.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Africa South of the Sahara / ethnology
  • Attitude to Health / ethnology*
  • Belgium / epidemiology
  • Counseling / statistics & numerical data*
  • Emigrants and Immigrants / statistics & numerical data
  • Fear / psychology*
  • Female
  • Focus Groups
  • HIV Infections / diagnosis*
  • HIV Infections / ethnology
  • HIV Infections / psychology
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / ethnology*
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data
  • Perception
  • Prejudice
  • Qualitative Research
  • Socioeconomic Factors
  • Voluntary Programs / statistics & numerical data
  • Young Adult