To test or not to test: psychosocial barriers to HIV testing in high‐income countries

Abstract

To contribute to the evidence-based understanding of the psychosocial factors that influence individuals' uptake of testing for HIV, we assessed and synthesized the pertinent published literature in the fields of public health, behavioural medicine, and (health) psychology. Although the evidence base appears too limited to allow firm conclusions and definition on psychological barriers to HIV testing in high-income countries, we identified convergent themes from the available studies. Testing for HIV seems to be more likely when individuals perceive that they have been at risk, though this association is not perfectly observed. Fear of the consequences of testing positive -mainly worries related to discrimination and rejection - also hinders HIV testing. Finally, individuals appear more likely to test for HIV when they perceive more benefits from testing. The perspective of targeted individuals, in particular the social connotations and consequences of HIV diagnoses, is crucial to understand testing decisions.

HIV Testing, Gay Community Involvement and Internet USE: Social and Behavioural Correlates of HIV Testing Among Australian Men Who have Sex with Men

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Sexually transmissible infection control programs for men who have sex with men – what will they look like in 2020?

“…14,64 Social stigmatisation of disclosing sexual behaviours, visiting facilities designated for sexual health services, and fear of testing positive for infection may prevent MSM from receiving appropriate care. 64,65 Also, cost undoubtedly limits care for certain groups of MSM. 14 Despite those barriers, there are a variety of clinic-based and decentralised services available to MSM, which are in need of expansion.…”

Gender, socio-economic status, migration origin and neighbourhood of residence are barriers to HIV testing in the Paris metropolitan area

“…Indeed, unlike in countries such as the United States or Great Britain, it is not legal in France to routinely categorize people into racial, French women from overseas territories (Halfen, 2008) or African women (Lydié, 2008) were published. More generally, studies that address barriers to and facilitators of HIV testing in high-income countries are scarce (De Wit & Adam, 2008;Deblonde et al, 2010), particularly those highlighting the situation of their minorities (Wohl, Tejero, & Frye, 2009) and their migrant populations (Stolte, et al, 2003;Fakoya, Reynolds, Caswell, & Shiripinda, 2008).…”