“The Anticipation Alone could Kill You”: Past and Potential Clients' Perspectives on HIV Testing in Non-Health Care Settings

Abstract

HIV testing in non-health care settings is an effective strategy for increasing the proportion of persons aware of their infection. We conducted 21 focus groups with 186 past and potential clients in five U.S. cities to explore attitudes and experiences related to HIV counseling and testing in non-health care settings. Qualitative analysis yielded several key themes. HIV-related stigma and fear emerged as a main theme throughout the discussions. Knowing one's HIV status quickly and accurately was of primary importance; HIV prevention counseling was secondary. Participants prioritized a supportive, nonjudgmental environment with adequate privacy and confidentiality. Provision of immediate emotional support, medical information, and linkage services to HIV-infected clients were considered essential. Staff with HIV-specific skills to address clients' emotional and informational needs was considered a strength of non-health care testing programs. Frequently, however, participants compared non-health care settings unfavorably to health care settings regarding privacy, competency, confidentiality, and test accuracy. Recommendations for enhancing counseling and testing services in non-health care settings are discussed.

College students and HIV testing: cognitive, emotional self-efficacy, motivational and communication factors

“…While the emotional response of fear was found to elicit reactance, the emotion of anger was said to encourage health-seeking behaviors [33]. In particular, anticipatory emotions about one’s HIV status could elicit fear toward HIV-testing [34]. Likewise, anxiety related to others’ awareness of one’s potential or actual HIV status, including not wanting to be seen by people at a testing facility, was also reported as a deterrent for HIV testing (e.g.…”

“…Perceived social stigma associated with HIV testing was found to elicit fear of social discrimination from others [40] and was an impediment to testing [34,41]. Individuals who have never been tested for HIV are said to experience greater HIV stigmas than those who have been tested; untested individuals also reportedly exhibit greater disapproval toward those who are HIV positive [42].…”

“…Individuals who have never been tested for HIV are said to experience greater HIV stigmas than those who have been tested; untested individuals also reportedly exhibit greater disapproval toward those who are HIV positive [42]. Self-denial of one’s potential HIV-positive status was also a barrier to seeking HIV testing [34]. Moreover, those who felt a positive HIV diagnosis would be a ‘death sentence’ were found to perceive little benefit from receiving an HIV test [34].…”

“…Self-denial of one’s potential HIV-positive status was also a barrier to seeking HIV testing [34]. Moreover, those who felt a positive HIV diagnosis would be a ‘death sentence’ were found to perceive little benefit from receiving an HIV test [34]. When people feel that they are not vulnerable to the HIV risk, they also lack the motivation to test for HIV [40].…”

Bridging barriers to clinic-based HIV testing with new technology: translating self-implemented testing for African American youth

“…National data indicate that approximately 87 % of people are HIV tested at medical facilities (e.g., 41 % at sexuality transmitted infection or community health clinics, 14 % at correctional medical facilities), while only 7 % are tested at community-based organizations and 6 % at substance abuse treatment centers [8]. In general, there are significant barriers to clinic-based HIV testing for adolescents, including inconvenience (e.g., time, location, transportation), confidentiality concerns, and fears of being socially stigmatized if observed attending a testing site [9][10][11][12][13][14]. HIV selfimplemented testing (SIT) offers a viable option for addressing these problems by increasing privacy and convenience [e.g., see 15].…”