24.1.2  The barriers to HIV testing

Barriers to HIV testing are those obstacles that prevent people from getting tested, either voluntarily or when offered a test by a healthworker. These barriers fall into three categories: client-related, healthworker-related and health facility-related. Examples of client-related barriers include fear of stigma, shame or disapproval attached to something regarded as socially unacceptable, and discrimination (unfair treatment of people found to be HIV-positive). Other client-related barriers include the fear of being ill and dying from a non-curable disease, if the test is positive for HIV infection; the loss of family support; and difficulties of keeping or finding a job.

Healthworker-related barriers include the fear of damaging the patient-provider relationship; the unpredictability of the patient’s emotional reaction; lack of time; and fear of overwhelming the client. Examples of health facility-related barriers are lack of space, equipment and supplies.