ArticleBMC health services research2012
The burden of knowing: balancing benefits and barriers in HIV testing decisions. a qualitative study from Zambia.
Article in BMC health services research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 90 citations in OpenAlex.
- Facilitators and barriers for HIV-testing in Zambia: A systematic review of multi-level factors.PloS one · 2018Pooled it
- Pooled it
- Systematic review of mobile health behavioural interventions to improve uptake of HIV testing for vulnerable and key populations.Journal of telemedicine and telecare · 2017Pooled it
- A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa.BMC public health · 2013Pooled it
- HIV and Sexually Transmitted Infection Testing Among Substance-Using Sexual and Gender Minority Adolescents and Young Adults: Baseline Survey of a Randomized Controlled Trial.JMIR public health and surveillance · 2022Trial
- Trial
- Rural-urban determinants of HIV/AIDS testing uptake among Ghanaian women of reproductive age.BMC public health · 2025Article
- HIV testing acceptance and its associated factors among key and priority populations in Harar town, Harari region, Eastern Ethiopia.BMC infectious diseases · 2025Article
- Decision-making and role preferences for receiving individual pharmacogenomic research results among participants at a Ugandan HIV research institute.BMC medical ethics · 2025Article
- Physician-Patient Interaction Quality Mediates the Association Between HIV-Related Stigma and HIV-Prevention Behaviors Among Sexual Minority Men in Zambia.AIDS and behavior · 2024Article
- 'Research ethics · 2024Article
- Stakeholder perspectives on interventions to improve HIV pre-exposure prophylaxis uptake and continuation in Lesotho: A participant-ranked preferences study.PLOS global public health · 2023Article
- Acceptability and perceptions of HIV oral self-testing across settings: A comparative qualitative study among Dominican and Tanzanian female sex workers.Global public health · 2022Article
- HIV testing and linkage to care-A case of a mobile diagnostic and counseling service in Mbeya, Tanzania; A quantitative study.PLOS global public health · 2022Article
- Lived experiences of people living with HIV: a descriptive qualitative analysis of their perceptions of themselves, their social spheres, healthcare professionals and the challenges they face daily.BMC public health · 2021Article
- Social-Cognitive Determinants of HIV Testing Among Tuberculosis Infected Patients in Kassala State, Sudan.Frontiers in public health · 2021Article
- Article
- The impact of HIV knowledge and attitudes on HIV testing acceptance among patients in an emergency department in the Eastern Cape, South Africa.BMC public health · 2020Article
- Using Anderson's Model of Health Service Utilization to Assess the Use of HIV Testing Services by Sexually Active Men in Ghana.Frontiers in public health · 2020Article
- Uptake and correlates of HIV testing among men in Malawi: evidence from a national population-based household survey.BMC health services research · 2019Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClient-initiated HIV counselling and testing has been scaled up in many African countries, in the form of voluntary counselling and testing (VCT). Test rates have remained low, with HIV-related stigma being an important barrier to HIV testing. This study explored HIV testing decisions in one rural and one urban district in Zambia with high HIV prevalence and available antiretroviral treatment.
methodsData were collected through 17 in-depth interviews and two focus group discussions with individuals and 10 in-depth interviews with counsellors. Interpretive description methodology was employed to analyse the data.
results'To know your status' was found to be a highly charged concept yielding strong barriers against HIV testing. VCT was perceived as a diagnostic device and a gateway to treatment for the severely ill. Known benefits of prevention and early treatment were outweighed by a perceived burden of knowing your HIV status related to stigma and fear. The manner in which the VCT services were organised added to this burden.
conclusionsThis study draws on social stigma theory to enhance the understanding of the continuity of HIV related stigma in the presence of ART, and argues that the burden of knowing an HIV status and the related reluctance to get HIV tested can be understood both as a form of label-avoidance and as strong expressions of the still powerful embodied memories of suffering and death among non-curable AIDS patients over the last decades. Hope lies in the emerging signs of a reduction in HIV related stigma experienced by those who had been tested for HIV. Further research into innovative HIV testing service designs that do not add to the burden of knowing is needed.
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