HIV testing attitudes, AIDS stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa

Abstract

Objectives: A cornerstone of HIV prevention in South Africa is voluntary HIV antibody counselling and testing (VCT), but only one in five South Africans aware of VCT have been tested. This study examined the relation between HIV testing history, attitudes towards testing, and AIDS stigmas. Methods: Men (n = 224) and women (n = 276) living in a black township in Cape Town completed venue intercept surveys; 98% were black, 74% age 35 or younger. Results: 47% of participants had been tested for HIV. Risks for exposure to HIV were high and comparable among people tested and not tested. Comparisons on attitudes toward VCT, controlling for demographics and survey venue, showed that individuals who had not been tested for HIV and those tested but who did not know their results held significantly more negative testing attitudes than individuals who were tested, particularly people who knew their test results. Compared to people who had been tested, individuals who were not tested for HIV demonstrated significantly greater AIDS related stigmas; ascribing greater shame, guilt, and social disapproval to people living with HIV. Knowing test results among those tested was not related to stigmatising beliefs. Conclusions: Efforts to promote VCT in South Africa require education about the benefits of testing and, perhaps more important, reductions in stigmatising attitudes towards people living with AIDS. Structural and social marketing interventions that aim to reduce AIDS stigmas will probably decrease resistance to seeking VCT.

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

“…Individuals with more equitable views around how people with HIV/AIDS should be treated were more likely to have tested for HIV and those with more blame/shaming attitudes were less likely to have tested. Similar findings have been noted from a study in Cape Town, where individuals who reported greater AIDS-related stigmas were also less likely to have tested (Kalichman and Simbayi 2003). Overall, mean scores for the shame/blame dimension of the stigma scale indicated relatively low levels of shaming attitudes towards people with HIV/AIDS among this population.…”

“…This is higher than that reported in a national household survey conducted in 2005 where only 30% of respondents reported having been tested for HIV (Shisana and Simbayi 2005). However, this figure is close to the percentage reporting having been previously tested for HIV among participants recruited from multiple venues in Cape Town, South Africa (47% reported having been tested previously) (Kalichman and Simbayi 2003). The difference in the percentage who report having previously tested may be due to the difference in sampling venues; the lower percentage in the household survey likely reflects the inclusion of individuals with less access to health care services.…”

“…However, uptake of VCT remains limited in many settings, even when available (Kalichman and Simbayi 2003). Stigma and negative attitudes towards HIV testing play an important role in the limited uptake of VCT in South Africa (Mwamburi et al 2005;Smith and Morrison 2006).…”

Health services utilization during terminal illness in Addis Ababa, Ethiopia

“…Because it has often been argued that the choice of health service is conditioned by the type of disease and concepts of its etiology (Kroeger 1983), we are interested in possible differences in health services utilization by cause of death. For some conditions such as HIV/AIDS, stigma is often also considered an impediment to accessing health care (Awusabo-Asare and Anarfi 1997;Admassu 2000;Valdiserri 2002;Kalichman and Simbayi 2003). Our study also provides a baseline for identifying change in health services use following the rollout of antiretroviral therapy.…”

Socio-Economic Determinants of Stigmatization and HIV Testing in Lesotho

“…Among others, Holzemer et al (2009) document the levels of HIV stigma reported by persons living with HIV and nurses in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Further studies have also shown that stigma is a barrier to HIV testing (Day et al, 2003;Ehiri, Anyanwu, Donath, Kanu, & Jolly, 2005;Kalichman & Simbayi, 2003;Mahajan et al, 2008;Nyblade, Stangl, Weiss, & Ashburn, 2009;Obermeyer & Osborn, 2007;Weiser et al, 2006;Wolfe et al, 2008). For example, Meiberg, Bos, Onya, and Schaalma (2008) reported that the main barriers for testing were ''fear of being stigmatised'' and ''fear of knowing their HIV-positive status'' among a sample of South African students.…”