@article{PAR00013846,
  title = {{R}ewards and challenges of providing {HIV} testing and counselling services : health worker perspectives from {B}urkina {F}aso, {K}enya and {U}ganda},
  author = {{B}ott, {S}. and {N}euman, {M}. and {H}elleringer, {S}. and {D}esclaux, {A}lice and {E}l {A}smar, {K}. and {O}bermeyer, {C}. {M}.},
  editor = {},
  language = {{ENG}},
  abstract = {{T}he rapid scale-up of human immunodeficiency virus ({HIV}) testing, counselling and treatment throughout sub-{S}aharan {A}frica has raised questions about how to protect patients' rights to consent, confidentiality, counselling and care in resource-constrained settings. {T}he {M}ulti-country {A}frican {T}esting and {C}ounselling for {HIV} ({MATCH}) study investigated client and provider experiences with different modes of testing in sub-{S}aharan {A}frica. {O}ne component of that study was a survey of 275 {HIV} service providers in {B}urkina {F}aso, {K}enya and {U}ganda that gathered quantifiable indicators and qualitative descriptions using a standardized instrument. {T}his article presents provider perspectives on the challenges of obtaining consent, protecting confidentiality, providing counselling and helping clients manage disclosure. {I}t also explores health workers' fear of infection within the workplace and their reports on discrimination against {HIV} clients within health facilities. {HIV} care providers in {B}urkina {F}aso, {K}enya and {U}ganda experienced substantial rewards from their work, including satisfaction from saving lives and gaining professional skills. {T}hey also faced serious resource constraints, including staff shortages, high workloads, lack of supplies and inadequate infrastructure, and they expressed concerns about accidental exposure. {H}ealth workers described heavy emotional demands from observing clients suffer emotional, social and health consequences of being diagnosed with {HIV}, and also from difficult ethical dilemmas related to clients who do not disclose their {HIV} status to those around them, including partners. {T}hese findings suggest that providers of {HIV} testing and counselling need more resources and support, including better protections against {HIV} exposure in the workplace. {T}he findings also suggest that health facilities could improve care by increasing attention to consent, privacy and confidentiality and that health policy makers and ethicists need to address some unresolved ethical dilemmas related to confidentiality and non-disclosure, and translate those discussions into better guidance for health workers.},
  keywords = {{A}ttitude of health personnel ; {B}urkina {F}aso ; confidentiality ; consent ; counselling ; delivery of health care/standards ; disclosure ; {HIV}/{AIDS} ; {HIV} infections/diagnosis ; {K}enya ; {U}ganda ; {BURKINA} {FASO} ; {KENYA} ; {OUGANDA}},
  booktitle = {},
  journal = {{H}ealth {P}olicy and {P}lanning},
  volume = {30},
  numero = {8},
  pages = {964--975},
  ISSN = {0268-1080},
  year = {2015},
  DOI = {10.1093/heapol/czu100},
  URL = {https://www.documentation.ird.fr/hor/{PAR}00013846},
}