BUSHBUCKRIDGE, South Africa – The walls of Shadrack Mashabane’s cabin in the rural South African town of Bushbuckridge are covered in traditional fabrics, with a small window as the only source of light. What stands out among the herbs and medicines in glass bottles is a white box containing an HIV test kit.
Mashabane is one of at least 15 traditional healers in the city who, in a pilot study, were trained by researchers at the University of the Witwatersrand to carry out HIV testing and counseling in an effort to ensure that as many South Africans as possible know their HIV status. state.
It is part of the largest known effort in the country to involve traditional healers in a public health objective and study the results. Later this year, at least 325 more healers will undergo training and become certified HIV counselors. Researchers will compare HIV testing rates by healers and clinics.
Most traditional healers already had knowledge about HIV – some from experience – and were eager to get involved, researchers said.
South Africa has one of the highest HIV rates in the world. Stigma remains in many communities around the disease and its treatment – even though antiretroviral medication and pre-exposure prophylaxis for HIV are free. Concerns about privacy in clinics also prevent people from seeking help.
Many people in rural areas see traditional healers as their first point of contact for illnesses, and the project hopes they can help change attitudes.
South Africa’s large young population is a particular concern. A government study released in December showed that people living with HIV fell from 14% in 2017 to 12.7% in 2022, but HIV prevalence increased among girls aged 15 to 19, a phenomenon largely attributed to older men who sleep with them.
Around 2,000 traditional healers operate in the town of Bushbuckridge, Mpumalanga province, where around 750,000 people live, providing traditional and spiritual services.
Mashabane said patients initially had difficulty believing he was offering HIV testing – a service they had long expected would only be available at health clinics.
“Many were not convinced. I had to show my certificate to prove I was qualified to do this,” he said.
The process includes signing consent forms to be tested, along with following up with Mashabane to ensure that patients who test positive receive treatment at the local clinic.
He said breaking the news to a patient who has tested positive for HIV is not that difficult because the disease can be treated with readily available medicines. But, in many cases, he has to accompany the patient to the clinic “to make it easier for him”.
Florence Khoza is another traditional healer who has been trained to test for HIV. She said risky sexual behavior is common. She often dispenses with traditional herbs and medicines to treat gonorrhea, but now goes further by advising patients to get tested for HIV.
“I tell them it’s in their best interest,” she said.
Khoza said many patients fear going to the clinic or hospital and having other members of the community see them receiving HIV treatment.
“In many cases, I collect HIV medications on their behalf,” she said.
Ryan Wagner, senior researcher on the study, said testing and treatment through traditional medicine professionals could “ultimately lead to an end to new cases of HIV in communities like rural Mpumalanga, which has one of the highest burdens of HIV worldwide”.
The researchers hope their findings will inspire the South African government to implement this training across the country.
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