There is evidence that some sub-Saharan African individuals suspect that they are HIV positive before diagnosis but delay being tested for HIV. This increases the likelihood of being diagnosed late (with a severely compromised immune system), a phenomenon that has been observed in sub-Saharan Africans diagnosed in the UK. Late diagnosis has negative personal and public health consequences. There is a lack of understanding of the psychological processes associated with delayed HIV-testing. This study used a Grounded Theory methodology. It aimed to produce a theoretical model to explain the psychological processes associated with delayed HIV testing in sub-Saharan Africans in the UK but also how these processes changed over time and contributed to the decision to test. Seven HIV-positive sub-Saharan African individuals from a London HIV clinic and one from a HIV charity were interviewed about their experiences. Analysis led to the development of a theoretical model of delayed HIV testing. This model consisted of three theoretical codes: moving in and out of uncertainty about HIV infection; preferring not to know HIV status; and making the decision to test for HIV. Participants' HIV risk perception fluctuated and was characterised by uncertainty. This, in combination with a preference to not know their HIV status due to a number of feared consequences of being HIV-positive, deterred them from testing. Participants' thoughts and feelings about knowing their HIV status changed over time. These changes were that they: wanted certainty, had hope of being HIV-negative and/or a hope for treatment and life and preparing for and accepting a potentially positive result. The findings can inform interventions to reduce delayed testing and suggest: a) intervening with ambivalence on an individual level and b) promoting awareness of HIV c) promoting the benefits of testing/costs of not testing at a population level. The findings are discussed in relation to existing research and theory. Strengths and limitations of the study are discussed, as are clinical implications and suggestions for future research.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:628546 |
| Date | January 2014 |
| Creators | Howells, Jessica |
| Publisher | Royal Holloway, University of London |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://digirep.rhul.ac.uk/items/8f400a67-d03b-decb-7dca-416308365ea3/1/ |
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