The study explored the knowledge and use of Voluntary Counselling and Testing (VCT) services by a stratified
random sample of 609 older adults from four purposively selected districts in Botswana. Only 76.8% of the older
adults had taken an HIV test and 51.6% of this number actually requested the test (client initiated). More than 20%
have engaged in a sexual relationship with a person whose HIV status they did not know. While 91% of older adults
indicated that everyone should undergo HIV test and 96.2% know where to get the HIV test but less than 16% of them
know that people who have unprotected sex, people who think they have sex with HIV infected persons and people
who have direct dealings with needles and tattoos should be tested. The identified main barriers to taking HIV test were
not feeling at risk of HIV infection (76.8%), fear of testing positive because of the reactions of partner(s) (10.9%), and
fear of testing positive because others will judge / treat them badly (8%) were. The study shows that being educated,
older than 59 years, married, female, coming from a rural location and having a negative HIV status increase the
likelihood of intention to use VCT services. The study recommends that education, which targets the needs of older
adults, about HIV and AIDS and VCT needs to be improved in order to enhance the uptake of VCT services, an
essential step for the initiation of treatment. In addition, home-based, door-to-door HIV testing, which will increase the
number of older adults to be tested, and create opportunities for increased knowledge of HIV transmission, prevention
and care through provision of correct information to older adults in their homes should be instituted.