Barriers and pathways to testing among HIV-infected women.

Through in-depth interviews the testing experiences of HIV-infected women were examined. The barriers that impeded the women from recognizing their at-risk status and from seeking testing once their vulnerability was acknowledged are discussed. Also described are the pathways that led women into testing. The data reveal that lack of understanding about risk behaviors, ignorance of their partner's risk practices, lack of information about HIV-related symptoms, and perceived invulnerability to infection were the principal barriers to women recognizing their at-risk status. The women's accounts also indicate that psychological factors--fear and denial--are the principal barriers to seeking testing once one acknowledges vulnerability. Finally, the data show that few women made a thoughtful proactive decision to be tested but rather seemed to be led by circumstances to learn their status, sometimes unwittingly.