TABLE 2.
Personal and community barriers to diagnostic testing and their associated psychological consequences, according to community health workers and Promotor/as
| Barriers sub‐categories | Sample quotations | Psychosocial consequences | |
|---|---|---|---|
| Fear | 1. Becoming infected or exposed | They were afraid that there would be a lot of people [at the testing centre], and … if they were not sick that there was a possibility of getting infected by going. |
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| 2. Getting others sick | I felt like a putrid person … because [the clinic staff member] is blaming me for infecting others … there is a stigma … you got people sick because you did not use protection and people are going to find out about that … it is feeling the guilt of knowing that you are responsible if somebody else gets sick. | ||
| 3. Uncovering other diseases (e.g., STDs, HIV) | I am working with the LGBTQ community and they are scared that something else might come up: HIV, AIDS, STDs … that is another fear, that you may go for COVID, but you will bring back more diseases. | ||
| 4. Failure (i.e., self‐care, care for family, care for community) | Nobody wants to look like they failed … they failed to – to take care of themselves, they failed to keep their families safe, and they feel like they let the community down. They are just embarrassed. | ||
| 5. Discrimination | People are afraid to test positive because they are going to be discriminated against … they will get labelled … their families will find out they had the virus, so they will not want to get close to them… their families can make them feel less because now they have the virus, they do not want to visit with them … It is a type of discrimination. | ||
| There are a lot of people who do not want to say they have had it or that they have it, because of fear of rejection … if someone says that they have it … [the community looks] at them weird … do not touch them, do not look at them … do not visit them. | |||
| 6. Caregiving concerns | If you are sick and people don't want to be near you, who is going to help you, right? It is that sense of being left alone and left behind. | ||
| 7. Job or income loss if testing positive | People are afraid to say they have the virus because they are afraid that they are going to be sent home, and they will not get paid … there is fear of lack of employment. | ||
| If I test positive, I am going to have to stay home and not work … I can't miss work … I have bills to pay … I am afraid of getting tested because what if I am [positive]? Who is going to pay for the bill … that is the worst fear. | |||
| 8. Immigration legal status |
There were immigration trucks parked in one of the testing sites [at the border] …. when people who are undocumented see the truck, they leave … they tell me, “they are going to take down my information there, and what if they pick me up?” |
||
| Mistrust | 1. Mishandling personal information | Their biggest worry is to give out their personal information and that they are tracked … we hear that for people who test positive, human services are taking their children away … and they would rather not get it done, so they do not get them separated. |
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| People are terrified of getting tested because they are fearful that the government will track them and follow them … there are immigration trucks parked in one of the testing sites … when people see the truck, they leave … they tell me, “They are going to take down my information and what if they pick me up?” | |||
| 2. Concern about financial scams | There is a rumour going around and people feel fearful … supposedly, for every positive test, the hospital or the clinic receives an X amount of money from the state so they are giving false positives just to get money. They do not have… | ||
| Myths/Beliefs | 1. Rumours | A lot of people are saying that they regret getting tested because there is a rumour that those [testing positive] will be the first to receive the vaccine, whether they want to or not, because they had the virus already … that sets us back a step in having people going in to get tested. |
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| [People] are afraid to get tested because they are afraid that the test may have the virus … they are afraid they may be inserting the virus through the test … there is a conspiracy and [testing] is government's way of eliminating the weak. | |||
| 2. Spiritual/religious beliefs | Why has this whole wrath of God arrived? … People say, the wrath of God is on this country or this community or these people … it is a lot about God being upset, so when somebody from the community gets COVID, it is hard to accept because it is, like, wait a minute. We were supposed to be protected. | ||
LGBTQ, lesbian, gay, bisexual, transgender, queer; STD, sexually transmitted disease.