One claimed benefit from getting tested for HIV that I’ve often heard, and may have even taught my students at Marurani and Maji Moto primary schools back in the day, is that “only by knowing your HIV status can you protect yourself and your partners.”
Bullshit. You can do both, right now, by using a condom every time you have sex. And guess what the strategy will be if you get a positive result? Use a condom every time you have sex. Testing is really helpful for the “be faithful to one partner” prevention strategy, but it’s not necessary for self-protection. As long as condoms are on the table, there’s no benefit from testing in terms of being able to protect oneself from the virus.
This matters, because people have enough problems with perceived agency in protecting themselves from infection already, and because testing can be very expensive, if not financially, then psychologically, emotionally, socially, and in terms of time spent doing it. Few Malawians, for example, seek it out. We’re giving people another reason not to take HIV-preventive action.
On the other side, policymakers generally assume that telling people their test results will translate into people knowing and believing their true status. I’m increasingly dubious. A friend of mine sat in on some result deliveries (I am not sure why this was allowed, and so will not name names) and they* told me they saw 7 people learn their status. 2 tested positive, and calmly accepted the result (at least outwardly). 5 were negative, and most of these were shocked and incredulous: “No – I must have HIV! I’m so sick!”
Doubt in test results is actually right in line with my own initial work on people’s HIV prevention choices in the face of massive perceived infection risk. I’m currently playing with extensions to that paper that explicitly incorporate disbelief in tests.
*Yes, I’m using “they” in the gender-neutral pronoun sense that dates back to the origins of the English language. Take that, historically myopic grammarians!