Volume 23 - Article 32 | Pages 905-932

Asking God about the date you will die: HIV testing as a zone of uncertainty in rural Malawi

By Amy Kaler, Susan Watkins, Ph D

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Date received:22 Jan 2009
Date published:09 Nov 2010
Word count:8647
Keywords:ambivalence, HIV testing, Malawi
DOI:10.4054/DemRes.2010.23.32
 

Abstract

Testing for HIV is becoming more available in Africa. Global advocates of testing see it as key to AIDS prevention. However, testing is not always perceived as a good thing by people at risk. Here, we consider testing from the perspective of people in a high-prevalence community. Using qualitative data from rural Malawi, we show that the decision to test is not as straightforward as suggested in the testing advocacy literature, but is marked by uncertainty and ambivalence. Reluctance to test is connected to the perception that testing inevitably leads to a positive diagnosis, and subsequent deterioration and death. This fear is in turn linked to overestimation of the transmissibility of HIV. We recommend that testing advocates address this concern that being tested means having a death sentence pronounced, and emphasize the benefits of testing for the majority who are HIV-negative, as well as the minority who are HIV-positive.

Author's Affiliation

Amy Kaler - University of Alberta, Canada [Email]
Susan Watkins, Ph D - University of Pennsylvania, United States of America [Email]

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