Traditional healer-initiated HIV counseling and testing in rural South Africa

HIV testing in South Africa has been undermined by HIV stigma, distrust in the health system, a preference for traditional medicine, and distance to the health facility. Only 33.9% of adults in rural Mpumalanga (our study site) underwent HIV testing in the past year. In South Africa, people of low socioeconomic status, men, and immigrants also have high HIV stigma and are less likely to receive an HIV test. The development of a Healer-Clinician HIV Prevention Collaborative (HICT) will facilitate testing and preventive service linkage among those who have traditionally avoided/refused testing. We propose an individually randomized controlled trial to compare HIV testing uptake among non-testers randomly assigned to HICT or health facility-based testing (HCT) (n=288). We hypothesize that healers can effectively test and link hard-to-reach patients with high levels of HIV stigma while enhancing patient-provider relationships. The Specific Aims include: (1) Conduct qualitative interviews with "non-testers" from varied socioeconomic and demographic groups to understand the complexities of HIV stigma and other interrelated identities; (2) Adapt a successful community-based HIV Prevention Project to create a Healer- Clinician HIV Prevention Collaborative; and (3) Compare HIV testing uptake and linkage to prevention services among participants offered healer-initiated versus facility-based counselling and testing.

Scholars @ ECU