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'It is better to die': experiences of traditional health practitioners within the HIV treatment as prevention trial communities in rural South Africa (ANRS 12249 TasP trial)
- Source :
- AIDS Care, AIDS Care, 2016, Aids Care : Psychological and Socio-Medical Aspects of Aids/Hiv, 28 (sup3), pp.24-32. ⟨10.1080/09540121.2016.1181296⟩, AIDS care
- Publication Year :
- 2016
- Publisher :
- Informa UK Limited, 2016.
-
Abstract
- International audience; The ANRS 12249 Treatment-as-Prevention (TasP) cluster-randomized trial in rural South Africa uses a test and treat approach. Home-based testing services and antiretroviral treatment initiation satellite clinics were implemented in every cluster as part of the trial. A social science research agenda was nested within TasP with the aim of understanding the social, economic and contextual factors that affect individuals, households, communities and health systems with respect to TasP. Considering the rural nature of the trial setting, we sought to understand community perceptions and experiences of the TasP Trial interventions as seen through the eyes of traditional health practitioners (THPs). A qualitative study design was adopted using four repeat focus group discussions conducted with nine THPs, combined with community walks and photo-voice techniques, over a period of 18 months. A descriptive, interpretive and explanatory approach to analysis was adopted. Findings indicate that THPs engaged with the home-based testing services and HIV clinics established for TasP. Specifically, home-based testing services were perceived as relatively successful in increasing access to HIV testing. A major gap observed by THPs was linkage to HIV clinics. Most of their clients, and some of the THPs themselves, found it difficult to use HIV clinics due to fear of labelling, stigma and discrimination, and the ensuing personal implications of unsolicited disclosure. On the one hand, a growing number of patients diagnosed with HIV have found sanctuary with THPs as alternatives to clinics. On the other hand, THPs in turn have been struggling to channel patients suspected of HIV into clinics through referrals. Therefore, acceptability of the TasP test and treat approach by THPs is a major boost to the intervention, but further success can be achieved through strengthened ties with communities to combat stigma and effectively link patients into HIV care, including partnerships with THPs themselves.
- Subjects :
- Male
Rural Population
antiretroviral treatment
Research design
Biomedical Research
Health (social science)
Social stigma
Social Stigma
Alternative medicine
Psychological intervention
HIV Infections
South Africa
Discrimination, Psychological
0302 clinical medicine
Mass Screening
treatment-asprevention
030212 general & internal medicine
Qualitative Research
Traditional medicine
Focus Groups
HIV testing
3. Good health
traditional healers
Research Design
Female
0305 other medical science
Prejudice
Adult
medicine.medical_specialty
HIV stigma
Social Psychology
Anti-HIV Agents
[SHS.DEMO]Humanities and Social Sciences/Demography
HIV testing antiretroviral treatment treatment-asprevention traditional healers HIV stigma South Africa
Article
Interviews as Topic
03 medical and health sciences
medicine
Humans
AFRIQUE DU SUD
Mass screening
030505 public health
business.industry
Public Health, Environmental and Occupational Health
Patient Acceptance of Health Care
Treatment as prevention
Focus group
treatment-as-prevention
Family medicine
Perception
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
056
108
business
Qualitative research
Subjects
Details
- ISSN :
- 13600451 and 09540121
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- AIDS Care
- Accession number :
- edsair.doi.dedup.....f273744f1ebe829783eac7209500a238