Negotiating multiple barriers

Malawi is facing a severe HIV and AIDS epidemic with an estimated 12% of its population living with the virus. Health workers are on the front lines of the HIV epidemic and they face the risk of HIV infection in both their personal and professional lives. This mixed method study aimed to explore the enablers and barriers to HIV counselling and testing and antiretroviral therapy by health workers in Malawi. After qualitative data were collected through in-depth interviews with health workers in the Mchinji and Nsanje districts, a survey questionnaire was constructed and administered to 906 health workers in eight districts in Malawi. A majority (76%) of health workers surveyed reported having undergone HIV testing and counselling, of whom 74% reported repeat testing. A striking result of the study is that 22% of health workers reported testing after occupational exposure to HIV. The proportions of respondents reporting that they tested after experiencing symptoms, or self-testing for HIV were 11% each. The in-depth interviews and the survey revealed multiple challenges that health workers face to accessing HIV testing, counselling and treatment, including fear of a positive result, fear of stigma and lack of confidentiality. Additional barriers included health workers' personal acquaintance with those conducting testing, along with their perception of being "role models" which could exacerbate their fears about confidentiality. Given health workers' critical role in HIV delivery in Malawi, there is need to develop solutions to help health workers overcome these barriers

Confidentiality · Environmental health · Family medicine · Population · Psychiatry · Qualitative research · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Nursing

• Acceptability of HIV self-testing

  Open Access•Janne Krause, Friederike Subklew-Sehume et al.•BMC Public Health•2013

  Incluir item

• Uptake, Accuracy, Safety, and Linkage into Care over Two Years of Promoting Annual Self-Testing for HIV in Blantyre, Malawi

  Open Access•Augustine Choko, Augustine T Choko et al.•PLoS Medicine•2015

  Incluir item

• A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa

  Open Access•Maurice Musheke, Harriet Ntalasha et al.•BMC Public Health•2013

  Incluir item

• Why do marital partners of people living with HIV not test for HIV? A qualitative study in Lusaka, Zambia

  Open Access•Maurice Musheke, Sonja Merten et al.•BMC Public Health•2016

  Incluir item

• Voluntary HIV testing and risky sexual behaviours among health care workers

  Open Access•Fati Kirakoya‐Samadoulougou, Fati Kirakoya-Samadoulougou et al.•BMC Public Health•2013

  Incluir item

• How to “Live a Good Life”

  Open Access•Enid Schatz, Brian Houle et al.•Journal of Aging and Health•2018

  Incluir item

• Workplace interventions to reduce HIV and TB stigma among health care workers – Where do we go from here

  Open Access•Jacob S Siegel, Annalee Yassi et al.•Global Public Health•2015

  Incluir item

• Self-testing as strategy to increase the uptake of HIV testing in South Africa

  Alta C van Dyk•African Journal of AIDS Research•2013

  Incluir item

• African and Caribbean Nurses’ Decisions about HIV Testing

  Open Access•Jean Harrowing, Nancy Edwards et al.•AIDS and Behavior•2017

  Incluir item

• Fighting stigma, promoting care

  Caroline Masquillier, Edwin Wouters et al.•AIDS Care•2018

  Incluir item

• Barriers to HIV counselling and testing uptake by health workers in three public hospitals in Free State Province, South Africa

  Rabia Khan, Annalee Yassi et al.•AIDS Care•2015

  Incluir item

• Facilitating HIV Disclosure Across Diverse Settings

  Carla Makhlouf Obermeyer, Parijat Baijal et al.•American Journal of Public Health•2011

  Incluir item

• Aids-related discrimination in Asia

  Susan J Paxton, S Paxton et al.•AIDS Care•2005

  Incluir item

• Sexual risk-taking and HIV testing among health workers in Zambia

  Open Access•Karusa Kiragu, Thabale J Ngulube et al.•AIDS and Behavior•2006

  Incluir item

• We are also dying like any other people, we are also people

  Open Access•Marjolein Dieleman, Godfrey Biemba et al.•Health Policy and Planning•2007

  Incluir item

• Tackling Malawi's Human Resources Crisis

  Debbie Palmer•Reproductive Health Matters•2006

  Incluir item