Poor-quality health services and lack of programme support leads to low uptake of HIV testing in rural Mozambique

Abstract

Abstract Background—Mozambique has one of the world’s highest burdens of human immunodeficiency virus (HIV) infection. Despite the increase in testing services throughout the country, uptake of HIV testing has been low.Methods—To identify barriers to HIV testing we conducted a study in 6 rural districts in Zambézia Province. We recruited 124 men and women from the community through purposeful sampling to participate in gender-specific focus groups about barriers to HIV testing.Results—Participants noted three main barriers to HIV testing: (1) poor treatment by clinicians, including intentional disclosure of patient HIV status to other community members; (2) unintentional disclosure of patient’s HIV status through clinical practices; and (3) a widespread fatalistic belief that HIV will result in death among those infected, particularly given poor access to food.Conclusions—Improving quality and confidentiality within clinical service delivery, coupled with the introduction of food supplement programs should increase people’s willingness to test and remain in care for HIV disease.