HIV/AIDS is one of the most critical current global socio-economic problems. Apparently,
there is no country that has not suffered the epidemic. It is a disease that has crippled many
governments’ budgets and disrupted medical research, since no cure has been found. Thus it
has caused a lot of strain, especially, in the Third World, where poverty is a major problem.
This is mainly because of lack of resources and facilities, poor general health and long periods
of social unrest and economic disruption (Monkge,, 1999).
In 2005 it was estimated that 270,000 people in Botswana, with a total population of 1.7
million, were HIV positive www.globalhealthreporting.org (2007). However, in 2004 official
government sources put the incidence rate at 17 percent, a significant reduction from the
estimated 38 percent in 2003 (National Aids Coordinating Agency (NACA)). Despite the high
incidence rate, only a few thousand actually know their status (UNAIDS, 2006). Unfortunately,
many people are now so frightened of HIV that they prefer to remain ignorant rather than test
positive and be stigmatised. However, the diagnosis “HIV positive” no longer has to mean
imminent death. By running away from being tested until they are seriously ill, many people
with HIV unknowingly pass a death sentence on themselves and sometimes on others too.
Botswana is one of the countries hardest hit by the HIV/AIDS epidemic (Botswana Institute of
Development Policy Analysis (BIDPA) 2000). The government recognises the impact of the
epidemic and therefore offers free antiretroviral (ARV) drugs to HIV-positive citizens
(http://en.wikipedia.org/wiki/Botswana2007). Most Batswana have not tested for HIV and only
about 42 000 were taking ARV drugs (52% of the 75 000 estimated to be in need of ARV as of
December 2004) (WHO/UNAIDS, 2005), although this figure was expected to rise to about 55
000. It was hoped that by the end of 2005 at least 3 out of every 5 people who needed ARV
drugs would be covered by the ARV programme. However, access to all ARV drugs is based
on knowing one’s HIV status, which depends on testing by appropriate health institutions. The
paper therefore discusses the factors which prevent people from getting tested for HIV, the
importance of knowing one’s status, and measures that may attract people to get tested.