Barriers to HIV testing in Guatemala: A Qualitative Study

Background: Early detection and treatment decreases HIV transmission rates and leads to risk reduction in those who are diagnosed. HIV-infected Guatemalans typically present with late-stage disease. Objective: We employed qualitative methods to explore barriers to HIV testing in Guatemala. Methods: In depth, qualitative interviews were conducted in an HIV testing and treatment facility in Guatemala City. These were analyzed using the methods of Grounded Theory. Results: Four major barriers impeded HIV testing in our subjects: psychological factors, stigma/discrimination, gender roles/machismo, and systemic barriers to care. Many of our patients’ fears were grounded in a reality of discrimination, while the systemic problems of the healthcare system reflected misunderstandings and fears on the part of healthcare workers. Discussion: Our findings are consonant with the international literature. Our narrative suggested potential interventions; presenting HIV testing as a way to “save one’s life” instead of an “automatic death sentence” might foster HIV testing and earlier diagnosis