Impact of HIV-Related Stigma and Discrimination on HIV Testing Behaviors, and Interventions to Improve HIV Testing Uptake, in Northern Tanzania

abstract: Access to testing for the human immunodeficiency virus (HIV), as well as other care services related to HIV/AIDS, have greatly improved in Tanzania over the last decade. Despite the country’s efforts to increase the number of individuals who get tested for HIV annually, it is estimated that only 52.2-70.0% of people living with HIV (PLWH) knew their HIV positive status at the end of 2017. In addition, research in Tanzania has shown that HIV-related stigma and discrimination are widespread and contribute to low uptake of HIV testing and non-adherence to antiretroviral treatment (ART). In order to achieve the goals set forth by the Government of Tanzania and the Joint United Nations Programme on HIV/AIDS (UNAIDS), as well as move towards an AIDS-free generation, a deeper understanding of the stigma-related barriers to seeking an HIV test is necessary. This research aims to better understand the relationship between HIV-related stigma and attitudes towards HIV testing among community members in Northern Tanzania. In addition, it looked at the specific barriers that contribute to low uptake of HIV testing, as well as the impact of social networks on an individual’s motivation and willingness to get tested for HIV. In this research, community members in Meru District (N = 108, male = 69.4%, female = 28.7%) were surveyed using various validated instruments that covered a range of topics, including knowledge of HIV/AIDS, testing attitudes, and perceived risk of HIV infection. The mean overall score for correct answers on the knowledge measure was 69.8% (SD = 16.4). There were no significant group differences between individuals who had ever tested and individuals who had not tested in relation to HIV/AIDS knowledge or HIV testing attitudes. The factors that were significantly associated with getting an HIV test were knowing someone who had previously tested (p = 0.003), as well as openly discussing HIV testing within one’s social group (p = 0.017). Participants also provided qualitative responses for barriers to receiving an HIV test, motivations for getting tested, and suggested interventions for improving HIV testing uptake. The goal of this research is to develop recommendations for interventions that are better informed by attitudes and motivations for testing.Dissertation/ThesisMasters Thesis Biology 201