HIV testing practices of Zimbabwean physicians and their perspectives on the future use of rapid on-site tests

To improve HIV testing procedures, rapid on-site HIV tests have been introd uced in Zimbabwe. At present, little is Known about physicians' perspective s an the potential use of rapid tests in their clinics or about their curre nt laboratory-based testing practices. In a sample of 63 general practition ers in Harare, this study found physicians were generally testing individua ls, not couples, and an important reason for suggesting a patient be tested was medical symptoms; frequent reasons for patients requesting the rest we re insurance purposes, being about to get married or having suspicions abou t a partner A primary deterrent to physicians testing patients, even when p atients requested it, was fear of traumatizing them. Fifty-six per cent of the physicians believed rapid tests would increase the number of HIV tests they performed; significant associations were found between this belief and whether physicians ever chose not to test patients they suspected were HIV -positive (a positive association) and whether they chose not to test speci fically out of fear that patients would commit suicide (a negative associat ion). Prior to any expansion of testing with rapid rests, training in couns elling and confidentiality measures is essential, given that over half the medical personnel providing counselling to these physicians' patients had r eceived no training in pre- and post-test HIV counselling.