Results
In total, 24 interviews were needed to achieve data saturation. The participants (41-years-old in average) included 11 men and 13 women ( Table 1 ).
Barriers to the HIV Mass Screening Related to Sexuality
Most of interviewed patients associated HIV transmission with sexual relations, so they considered that the screening inevitably questioned their spouse's fidelity: "we cannot always have suspicions and get screened every 6 months" (female patient no. 2). Marriage was seen by some as a guarantee of fidelity and therefore made the screening unnecessary: "All married couples, if they're faithful, I don't think they need to be screened" (male patient no. 9). Similarly, religion (Catholicism in our study) was supposed to protect patients from high-risk relations: "young, very devout Catholics […] would only ever have sexual relations with their wife or husband […], they don't even talk about HIV at home" (female patient no. 24). Moreover, participants thought that sexuality was virtually inexistent among the elderly and questioned the need of screening for them: "For old people, I think it's not necessary […] I don't think 70-year-old people have a sex life" (female patient no. 2).
Criticism of Public Policies
Several patients, particularly those older than 40, considered the cost of public health to be another barrier. "Why incur those costs for the community?" (female patient no. 6). Criticisms concerned public health policies and communication aimed at the general public: anticipated benefits of screening and lack of information about screening methods. Information overload was also criticized as it could lead to information saturation and induce distrust in prevention campaigns: "Too much info kills the info. […] You get overloaded and you want to think about something else" (female patient no. 13).
HIV Beliefs and Perceptions
Fear of HIV-associated illness was considerable for some. Knowledge about this subject, even vague, only exacerbates this apprehension: "some people wouldn't dare to participate, because they're afraid […]. This disease scares people" (female patient no. 16). The fear of test result can add to that of the disease: "They're afraid to go find out the result" (male patient no. 9).
The lack of screening of 'others' was viewed critically: "I think they don't think they have any chance of catching it, they feel well and have no symptoms, they don't think they're carriers" (female patient 18). However, a concurrent feeling of being personally protected could exist: "Not everyone is in danger of catching that disease […] From that point of view, I'm completely safe" (male patient no. 4). Living in France could also provide a feeling of protection: "It depends on the country. I don't think France is much affected" (male patient no. 8).
Patients also reported the embarrassment that sometimes prevents them from discussing about HIV, even with their physician: "To be honest I thought of asking him, but I don't really dare ask the doctor" (female patient no. 19). "It's a taboo subject […] it's like it's something you shouldn't talk about" (male patient no. 23).