Making sense of HIV Testing: Social representations in young Africans' HIV-related narratives from six countries Open Access

Abstract

HIV testing and counseling is a critical intervention to support treatment access and
prevention of new infections. Despite high rates of infection and attempts to increase testing in
this age group, young Africans are those least likely to have tested for HIV. With the aim of
informing interventions that encourage HIV testing and promote healthy testing outcomes, this
study seeks to understand how young Africans imagine and make sense of HIV testing.
"Scenarios from Africa" scriptwriting contests invite young people to contribute ideas for short
films about HIV. Using thematic narrative-based approaches, we analyzed a stratified random
sample of 586 (~5%) of these narratives written in 2005 by males and females aged 10-24 from
Senegal, Burkina Faso, South-East Nigeria, Kenya, Namibia and Swaziland. The factors
influencing testing behavior and outcomes are represented as complex, interactive and
multifaceted. Personal perception of risk, whether low or high, was shown to both inhibit and
facilitate HIV testing. Social support from family, peers and the community was depicted as
instrumental in promoting testing and beneficial testing outcomes, such as preventative behavior
change and adoption of positive living. Counseling was represented as a crucial element of the
testing process. Young authors depicted the benefits of integrating testing into the standard
"ABC" ("abstinence", "be faithful", "use condoms") of HIV prevention. As multiple factors
mediate the testing decision-making process, one-dimensional interventions are unlikely to effect
a shift towards increased testing or more beneficial testing outcomes. Interventions need to
operate with greater understanding of the multi-layered and context-specific factors that motivate
and impede the decision to test. Despite current low levels of testing, the narratives demonstrate
the potential for favorable attitudes toward testing among young Africans and the opportunity to
increase HIV testing in this demographic.

Table of Contents

Table of Contents

Introduction..............................1
Literature Review.......................3
Manuscript..............................25
Contribution of the student........26
Abstract.................................27
Introduction............................28
Methods.................................29
Results...................................34
Discussion...............................52
Conclusion..............................59
Manuscript References..............61
Public Health Implications..........66
References.............................70

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Africa social representations testing youth HIV/AIDS
Committee Chair / Thesis Advisor	Winskell Enger, Kate, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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