Factors of Non-acceptance of the Routine HIV Test among Patients
Attending a District Hospital in Botswana
A. J. Lopang
*
, M. E. Hoque
**
and H. Heever
***
*
Athlone Hospital, Private Bag 20, Lobatse, Botswana
**
Graduate School of Business and Leadership, University of KwaZulu-Natal
(Westville Campus), South Africa
***
Department of Public Health, School of Health Care Sciences, University of Limpopo
(Medunsa Campus), South Africa
KEYWORDS Factors. Non-acceptance. Routine HIV Test. Patients. Botswana
ABSTRACT The purpose of this study was to assess the willingness to do HIV test and find factors for non-acceptance of
routine HIV testing among patients attending Athlone hospital in Botswana. This was a cross-sectional study in which 300
conveniently selected participants completed self-administered questionnaire. Results indicated that the average score for
willingness to test was 9.25 (range 1 to 12) and the non-acceptance of the routine HIV test was found to be 24.91 (range of
score 1 to 33). Majority (72%) responded positively that patients were testing freely. Almost two- third (64.7%) of the respondents
agreed that stigma and discrimination contributed towards refusal to test for HIV. Almost three quarters (73%) feared for
positive result and 40.3% agreed that attitude of health care workers was a barrier for RHT. The study found great support and
acceptance of routine HIV testing. However there were still concerns of stigma, discrimination and attitudes of health care
workers which were discouraging.
Address for correspondence:
Mr M. E. Hoque, MSc
Graduate School of Business and Leadership,
University of KwaZulu-Natal (Westville Campus),
South Africa
Telephone: +27 0312608690
E-mail: hoque@ukzn.ac.za, muhammad.ehsanul@gmail.com
INTRODUCTION
The impact of HIV/AIDS is severe in the Sub-
Saharan Africa. Southern Africa were hardest
hit countries with Botswana being one of them
(UNAIDS and WHO 2007). HIV/AIDS is a se-
rious socio-economic, cultural and medical is-
sue which is threatening the globe especially
the Sub-Saharan Africa. Approximately 10% of
the world population lives in sub-Saharan Af-
rica, but the region is home to approximately
64% of the world population living with HIV
(WHO and UNAIDS 2005). Most sub-Saharan
African nations have over 20% adults popula-
tion infected with HIV that is, South Africa with
adult prevalence of 21.5%, Swaziland with
38.3% followed by Botswana by 37.3% (WHO
2006). Surveys in Sub-Saharan Africa have
shown that just 12% men and 10% women had
been tested for HIV and received the results
(UNAIDS and WHO 2007).
Because of the secrecy, fear and stigma at-
tached to HIV/AIDS, many people were not test-
ing until it was sometimes too late to get proper
care and treatment. Anti retroviral drugs were
not yet available in most developing countries,
and they were not available until 2002 in
Botswana (NACA 2004). A Nigerian study
found discriminatory attitudes of health care
workers towards patients with HIV/AIDS (Reis
et al. 2005). According to Alcorn and Smart
(2006), the move towards routine or opt-out test-
ing has been greeted with caution and even re-
sistance by community-based organizations. The
routine offer of the test may in practice coerce
some people to undergo a test of which may re-
sult in serious discrimination, stigma and even
violence in some settings, especially for women.
Heywood (2005) reported to have said that con-
cerns still remain that RHT at health services
could be unacceptable to public, thereby deter-
ring health care seeking and harming popula-
tion health.
Objectives of the Study
The government of Botswana introduced the
routine HIV testing (RHT) policy in early 2004
in an effort to increase the uptake of HIV test-
ing and antiretroviral treatment. The goal be-
ing to increase the proportion of individuals
aware of their status and to reduce transmis-
sion, stigma and provide live saving treatment.
Political will and support was available to en-
sure the success of the RHT programme. There
are other views which support the policy such
© Kamla-Raj 2013 Ethno Med, 7(1): 7-11 (2013)