Routine HIV testing in Botswana: a population-based study on attitudes, practices, and human rights concerns

Area of Science:

• Public Health
• Epidemiology
• HIV/AIDS Research

Background:

• Botswana implemented routine (opt-out) HIV testing due to high HIV prevalence (37%).
• This policy aimed to increase testing and reduce stigma.
• Understanding public perception and correlates of testing is crucial.

Purpose of the Study:

• Assess knowledge and attitudes towards routine HIV testing in Botswana.
• Identify correlates and barriers to HIV testing 11 months post-policy implementation.
• Evaluate public perception of routine testing's impact on stigma and treatment access.

Main Methods:

• Cross-sectional, population-based study of 1,268 adults in Botswana.
• Assessed knowledge, attitudes, and self-reported HIV testing prevalence.
• Analyzed correlates of testing, including demographics, healthcare visits, and attitudes.

Main Results:

• 81% favored routine testing; most believed it would reduce barriers and stigma.
• 48% reported self-testing; correlates included female gender, higher education, and healthcare visits.
• Barriers included fear of status, perceived low risk, and potential lifestyle changes; 68% felt unable to refuse testing.

Conclusions:

• Routine HIV testing is widely supported in Botswana and may lower testing barriers.
• Ensuring informed consent and human rights safeguards is vital for routine testing.
• Measures are needed to protect against discrimination and partner violence related to HIV testing.