This is the first of the dilemmas considered here:
The stigma around HIV can be high. A diagnosis can lead to rejection by family and community, and in some instances, a person suspected to be HIV-positive may even be killed. Where MSF is not running a programme offering antiretroviral therapy or where referral is impossible, our laboratory staff, despite a clear policy, can fear informing or counselling individuals who test positive for HIV. In these contexts, our staff struggle with knowing the results and yet not informing the individual. Is there any way to reconcile this tension?