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Table 3 HIV testing issues

From: Evaluation of the HIV lay counselling and testing profession in South Africa

Category of issues Specific issues
Health systems issues - Frequent stock outs of test kits affecting clients participation
- Lack of working space for counsellors and testers
- Lack of some important work materials e.g. stopwatches
Testing guidelines and sensitivity of test kits - Low sensitivity of the G-ocean brand
- High usage of ELISA due to mistrust of rapid tests
- Constant changes in test kits
- Current test kits are not easy to recognise if there is little buffer or blood
- Often different results between screening and confirmatory tests
Low incentives/ lack of recognition/ workload - Low salary compared to tasks
- Delays in salaries
- Not considered as part of health facility staff
- Lack of re-training for counsellors and testers
- Extra work in the facility due to HCT but limited staff
- HCT too demanding and stressful, need more staff
- Emotional stress of counsellors and testers , thus need counselling and psychological support themselves
Stigma/fear/denial of HIV testing - Fear of staff members to test in the facility where they work
- Difficulties of testing oneself
- Difficulties of testing couples especially in relational issues
- Many men in denial of their results
- Positive youths react negatively after receiving results
- Difficult to maintain confidentiality in small communities