HIV testing access & uptake barriers of thai and ethnic minorities in northern Thailand

Objective: To better understand barriers obstructing access to HIV testing in Northern Thailand. Background: Using qualitative data from Thailand's Project Accept, access barriers to HIV testing experienced by Thai and ethnic minority participants were determined. Methods: Qualitative research methods (open and focused coding, theme development, memoing and integrative-memoing, conceptual framework construction) were applied to semi-structured in-depth interview transcripts using Atlast.ti and Microsoft Office software. Study sample (n=117, aged 18-32 years) included Thai (n=81) and ethnic minorities (n=36) representing Chinese, Pakistani, Thai-Yai, Black & Red Lahu, Lisu, Hmong, Akha, Karen, Zam and Kon-Muang ethnicities. Results: Primary HIV testing barriers were primarily due to fear and misperceptions. Fears included: needles used in testing, testing alone with no emotional support, results not being private, stigma/discrimination (e.g. belief one would be disowned by one's family, and isolated from one's community, if found HIV positive), HIV-diagnosis with no treatment options (i.e. HIV viewed as a death sentence). Testing barriers due to misperceptions included: testing perceived to be expensive (many were unaware free testing was available); perception no HIV treatment was available/existed (treatment is available to Thai nationals but not ethnic minorities), time for testing and waiting for results (although rapid testing was available in some locations). Physical access to testing a site was another barrier to testing. Conclusion: Many access barriers to HIV testing in Northern Thailand could be reduced by minimizing fear and misperceptions surrounding HIV through educational interventions. Future education intervention design should target fears and misperceptions to increase uptake of HIV testing.