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Asking God about the date you will die: HIV testing as a zone of uncertainty in rural Malawi

Author

Listed:
  • Amy Kaler

    (University of Alberta)

  • Susan Watkins

    (University of Pennsylvania)

Abstract

Testing for HIV is becoming more available in Africa. Global advocates of testing see it as key to AIDS prevention. However, testing is not always perceived as a good thing by people at risk. Here, we consider testing from the perspective of people in a high-prevalence community. Using qualitative data from rural Malawi, we show that the decision to test is not as straightforward as suggested in the testing advocacy literature, but is marked by uncertainty and ambivalence. Reluctance to test is connected to the perception that testing inevitably leads to a positive diagnosis, and subsequent deterioration and death. This fear is in turn linked to overestimation of the transmissibility of HIV. We recommend that testing advocates address this concern that being tested means having a death sentence pronounced, and emphasize the benefits of testing for the majority who are HIV-negative, as well as the minority who are HIV-positive.

Suggested Citation

  • Amy Kaler & Susan Watkins, 2010. "Asking God about the date you will die: HIV testing as a zone of uncertainty in rural Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 23(32), pages 905-932.
    • Handle: RePEc:dem:demres:v:23:y:2010:i:32
    DOI: 10.4054/DemRes.2010.23.32
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    References listed on IDEAS

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    1. Susan Cotts Watkins, 2004. "Navigating the AIDS Epidemic in Rural Malawi," Population and Development Review, The Population Council, Inc., vol. 30(4), pages 673-705, December.
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    Cited by:

    1. Nicole Angotti & Margaret Frye & Amy Kaler & Michelle Poulin & Susan Cotts Watkins & Sara Yeatman, 2014. "Popular Moralities and Institutional Rationalities in Malawi's Struggle Against AIDS," Population and Development Review, The Population Council, Inc., vol. 40(3), pages 447-473, September.
    2. Wilson, Nicholas, 2016. "Antiretroviral therapy and demand for HIV testing: Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 21(C), pages 221-240.
    3. Sterck Olivier, 2013. "Why are Testing Rates so Low in Sub-Saharan Africa? Misconceptions and Strategic Behaviors," Forum for Health Economics & Policy, De Gruyter, vol. 16(1), pages 219-257, September.
    4. Nicole Angotti & Amy Kaler, 2013. "The more you learn the less you know? Interpretive ambiguity across three modes of qualitative data," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 28(33), pages 951-980.
    5. Sikstrom, Laura, 2018. "“There was no love there”: Intergenerational HIV disclosure, and late presentation for antiretroviral therapy in Northern Malawi," Social Science & Medicine, Elsevier, vol. 211(C), pages 175-182.
    6. Parijat Chakrabarti & Margaret Frye, 2017. "A mixed-methods framework for analyzing text data: Integrating computational techniques with qualitative methods in demography," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 37(42), pages 1351-1382.
    7. Angotti, Nicole, 2010. "Working outside of the box: How HIV counselors in Sub-Saharan Africa adapt Western HIV testing norms," Social Science & Medicine, Elsevier, vol. 71(5), pages 986-993, September.

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    More about this item

    Keywords

    Malawi; HIV/AIDS testing; ambivalence;
    All these keywords.

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

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