Spousal and Community Influence on Reactions to VCT and Decision Making in Rural Malawi

Lauren Gaydosh, University of Pennsylvania

Faced with the staggering AIDS epidemic, several sub-Saharan African countries recently implemented voluntary counseling and testing (VCT) programs at hospitals and clinics, which may prove a critical component in HIV/AIDS prevention. Most VCT research up-to-date has examined the program impact using three limited measures of evaluation: behavioral change, partner roles, and community perception. With mostly quantitative information from population and clinic-based surveys, this research provides little detail about individual and community responses to VCT. This paper uses qualitative interviews to evaluate the effectiveness of VCT as an HIV treatment and prevention program with a specific focus on role of the spouse and the community in decision making of married individuals. Using in-depth qualitative interviews with married couples approached for VCT in rural Malawi, this paper explores reasons for consenting or refusing HIV testing, and the extent to which respondents discuss testing experiences with spouses and other members of their communities.