Consequences of HIV testing without consent

Abstract

The objective of this study is to explore the HIV-infected individuals' experience with HIV testing, counselling, disclosure of diagnosis and subsequent life events following diagnosis.

The method used is a questionnaire survey of 340 consecutive HIV-positive victims, seen in two health institutions in southeast Nigeria within a one-year-period, November 2003 to October 2004.

Three hundred and twenty respondents answered the questionnaire, 121 were men and 199 women, with 79% in the age range 20–39 years. Most respondents had known their HIV status for 3.2 (±1.1) years and the majority are in the lower social class. About 80% reported that their consent for HIV test was not asked for, resulting in feelings of fear, disbelief, shock and embarrassment on learning about their HIV status. Despite the initial reaction to the diagnosis, majority (81.9%) expressed satisfaction with the pattern of disclosure of diagnosis. There was some reluctance to inform spouse/partner of the diagnosis especially among asymptomatic, unmarried, childless or divorced victims. A serodiscordant couple resulted in mistrust and increased incidence of abandonment. Apart from spouse/partner the respondents are more likely to inform their siblings of the diagnosis than parents, children or friends. Despite being supportive, the respondents are more likely to suffer more neglect from siblings than their spouse (P<0.05) but the risk of being abandoned was more with the spouse than with siblings (P<0.05). Only 32.6% of the 129 respondents on antiretroviral therapy are regular with it mainly because of cost and non-availability of drugs. Default in treatment was more evident among the unmarried, those with low educational status and treatment with antiretroviral drugs for more than two years.

Proper pre- and post-test counselling, promotion of behavioural change among the society about HIV/AIDS and provision of support and cost-effective care for HIV victims is advocated.