Attitudes towards HIV Testing and Treatment

Attitudes towards HIV Testing and Treatment

Health psychology, sociology and social psychology boast of several theories that can be

employed to explain the relationship between knowledge, attitudes, skills, and social and

environmental influences on one hand and behaviour on the other. For example, to explain

how an individual succeeds in changing behaviour, the health belief model theories posit that

an individual must first believe that behaviour change is not only possible but also beneficial.

In addition, the individual must believe that the advantages of making behaviour change

outweigh any implied disadvantages (Rosenstock, Strecher, & Becker, 1988).

Besides belief, there is needs to consider one’s source of influence since a number of

adolescent adopting drug abuse behaviours. Therefore, researchers utilise such principles

of behaviour change theories to identify personal and social correlations of drug abuse

habits as well as physical activity behaviours.

Considering that self-efficacy is among key determinants of behaviour change; to promote it,

researchers recommend the use of motivational education techniques (Bakracevic & Licardo,

2010). As a result, behaviour change support theories were developed by examining

randomised and controlled psychological interventions among overweight or obese adults.

The study recommended the use of cognitive therapies combined with

components such as healthy eating habits and exercise as a strategy for weight

likelihood of one’s willingness to test for HIV, accept the test’s outcome and start

treatment. However, a clear understanding of HIV is a predictor of an individual’s

willingness to seek life-saving care and treatment, and in addition, provide the individual

with a rare chance of seeking counselling to reduce disease prevalence (Berlinger,

Jennings, & Wolf, 2013).

A study comparing the respondents’ HIV and AIDS knowledge and attitudes towards testing

among adults in Kano and Tennessee, revealed that majority (59%) of the participants lacked

knowledge of the organism causing HIV. Also, despite participants having generally a high

knowledge on the mode of HIV transmission, significant predictors of the HIV knowledge

remained the female gender and formal education (Chauhan, Bhardwaj, Parashar & Kanga,

The 2012 Kenya AIDS Indicator Survey found that women (79.8%) more than men

(62.5%) were likely to have ever tested for HIV. This is despite the proportion of adults

and adolescents showing a general upward trend from 34.3% in 2007 to 71.3% in 2012

(NASCOP, 2014). Furthermore, one in every five of those that had ever tested had done

so in the past 3 months, and over 50% within 12 months prior to the survey. Furthermore,

only 34.5% of the people who had visited a health facility during the same period had

been offered an HIV test and showed a high (91.5%) acceptance rate. Finally, the study

found that, of the participants who had never tested for HIV, over four fifths (83.2%

women and 81.3% men) accepted home-based testing and counselling services.

To deal with the HIV transmission risk, two components are necessary namely, knowledge

al., (2011) reported a transmission reduction of up to 96% among HIV discordant couples

using ARTs. Moreover, to control the generalized epidemics, universal HIV testing and

immediate antiretroviral treatment should be employed (Audet et al., 2012) since it is

expected to result in a major impact on the tuberculosis linked to the HIV pandemic

(Harries et al., 2010).

Despite HTC playing a crucial role in HIV programming, coverage in the SSA region

remains low. For instance, statistics for the SSA region measuring testing coverage in

population-based surveys for the period 2007 – 2008 were very wide. Coverage ranged

from 3.2% and 4.9% for women and men respectively in Liberia to 56.7% and 43.0% in

South Africa (WHO – UNAIDS – UNICEF, 2009). This is an indication that there exists

discrimination and negative perception of testing services (Kalichman, Cain, & Simbayi,

2010), concerns about confidentiality and shortage of counsellors as well as delays in

returning test results (Matovu, 2007), and, cost of transportation (Wanyenze et al., 2006).

Most recently, Kenya has focussed on HTC as a major feature of the HIV response

arguing that HIV testing is the gateway to seeking treatment. Towards that end, Kenya

has adopted various strategies whose roots can be traced to HTC. Such strategies include

in the year 2000 there were just three VCT sites compared with over 4,000 sites ten years

later. At the same time, whereas 860,000 people tested for HIV in 2008, five years later

the number had increased to 6.4 million people (NACC, 2014). It therefore follows that

both the number of testing sites and people being tested for HIV had increased greatly.

Although, annual testing rates have nearly doubled since 2008, there are still significant

gender differences. In 2014 for example, more women (53%) than men (45%) had tested

for HIV (KNBS, 2015). Therefore, to improve the testing rates among Kenyans, men in

particular, community-based testing programmes need to be implemented as they have

proved successful (UNAIDS, 2012).

As a result of implementing HTC, there has been a substantial increase in coverage

people hesitant to get tested (Chimoyi et al., 2015), thus, occasioning many infected

individuals to likely be unaware of their HIV status thereby putting their sexual partners

at risk of contracting the disease.

Besides, stigmatisation can result in detrimental actions and negative thoughts among

HIV actors such as governments, health care providers, employers, communities, family

members and colleagues (Zierler et al., 2000). But, more importantly, their actions are

likely to lead to a number of health consequences for PLWHA; among them, low self-

esteem, isolation, loneliness, identity crises and lack of interest in taking preventative

measures due to low care seeking behaviours (Altman et al., 2012). Furthermore, lack of

participation in VCT is likely to result in many pregnant women for example, ignoring

HIV testing (Fonner, Denison, Kennedy, Reilley, & Sweat, 2012; Teklehaimanot,

Teklehaimanot, Yohannes, & Biratu, 2016)

Another factor affecting HIV testing coverage is the attitudes individuals hold towards

Additionally, the study found out that women had less knowledge about HIV risks and

therefore considered their sexual behaviours risk free, thereby deflecting the HIV-related

stigma. Furthermore, it was more likely to self-identify testers as gays. It was observed

that both the MSM and gays avoided HIV testing for fear of test results turning positive.

Moreover, both groups entertained the belief that family members held negative attitudes

towards HIV testing and there was a high likelihood for confidentiality to be

compromised if a Latino staff served at the HIV testing sites.

To protect themselves from open ridicule, some population groups sometimes prefer

testing for HIV using methods that guarantee confidentiality. For example, studies have

found preference for rapid HIV home testing method by majority of the gay men and they

cite discretion, convenience, accessibility, rapid provision of results, increased privacy,

confidentiality, and anonymity as a justification for their choice (Bilardi et al., 2013;

Greacen, 2013).

concerns including lack of immediate professional support in the event the results turn

positive (Bilardi et al., 2013), perceived uncertainty about its accuracy (Sharma, Sullivan,

& Khosropour, 2011), dissimilarity with a sexual situation and associated costs

(Carballo-Dieguez, Frasca, Dolezal, & Balan, 2012). However, the potential for use

associated with the approach may include the following factors: high-risk sexual

behaviour(s) that require frequent testing (Bavinton et al., 2013; Greacen, 2013),

encouraging the desire for not seeing a doctor for HIV counselling (Bavinton et al.,

AIDS compared with 60% assessed as having good knowledge on risk factors associated

resulting in only 57% having tested for HIV. Although, most women (85%) were willing

to test for HIV, their primary concern was confidentiality due to the fear of how their

husbands, parents and the community would react (Hensen et al., 2012).

While accurate knowledge of the disease increases the chances of testing for HIV, there are

other factors that prevent individuals from doing so and they depend on the type of

population group one is looking at. For example, studies on HIV testing rates and outcomes

have found confidentiality, disclosure and consent issues to be among the most frequently

encountered barriers in HIV testing (Hyden, Allegrante, & Cohall, 2014; Peralta, Deeds,

Hipszer, & Ghalib, 2007). Similarly, a study that examined the acceptability of voluntary

counselling against HIV testing conducted by Ekanem and Gbadegesin, (2004) found a

knowledge of transmission pathways, but poor knowledge on PMTCT as well as the

relationship between breast milk and HIV transmission by nearly half of the respondents.

Available research evidence shows that HIV-testing brings about behavioural change and

reduction of infection risk as well as worry over possible infection. At the same time, testing

attitudes towards testing and treatment for HIV since, there is no study known to the

researcher that has investigated this issue and even if there were, definitely not in Kisii

central Sub-county. This study therefore, sought to fill this gap.

REFERENCES

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Adefuye, A., Abiona, T. C., Balogun, J. A., Amosun, S. L., Frantz, J., & Yakut, Y.

(2011). Perception of risk of HIV and sexual risk behaviours among students in

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Aspects of HIV AND AIDS, 8(1), 19-26.

APA, (2010). HIV AND AIDS and Socio-economic status. Retrieved from:

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