In the rural South African town of Bushbuckridge, traditional healer Shadrack Mashabane’s hut is adorned with traditional fabrics, herbs, and medicines. Among these familiar items, a white box containing an HIV testing kit stands out, symbolizing a groundbreaking initiative in the battle against HIV.
Mashabane is one of at least 15 traditional healers in Bushbuckridge participating in a pilot study conducted by researchers from the University of Witwatersrand. This initiative aims to train traditional healers in HIV testing and counseling, striving to ensure that more South Africans are aware of their HIV status. The program represents the largest known effort in the country to involve traditional healers in public health goals and study the outcomes.
Later this year, the program will expand to include at least 325 more healers, who will undergo training and become certified HIV counselors. Researchers plan to compare HIV testing rates conducted by these healers with those carried out in clinics.
South Africa faces one of the highest rates of HIV globally, with stigma surrounding the disease and its treatment persisting in many communities. Although antiretroviral medication and pre-exposure prophylaxis are freely available, concerns about privacy at clinics deter many from seeking help.
In rural areas, traditional healers often serve as the first point of contact for health issues. This project leverages their influence to change attitudes towards HIV testing and treatment. Ryan Wagner, a senior research fellow involved in the study, emphasized the potential impact: “Testing and treating via traditional medicine practitioners could ultimately lead to the end of new HIV cases in communities such as rural Mpumalanga, which has some of the largest HIV burden globally.”
South Africa’s younger population is particularly vulnerable. A government study released in December showed that while the overall HIV rate had fallen from 14% in 2017 to 12.7% in 2022, HIV prevalence rose among girls aged 15 to 19. This increase is largely attributed to older men engaging in sexual relations with young girls.
Mashabane and his colleagues face the challenge of convincing patients that HIV testing can be done outside clinics. “Many were not convinced. I had to show them my certificate to prove I was qualified to do this,” Mashabane said. Once patients consent to testing, Mashabane follows up to ensure those who test positive receive treatment from local clinics. He often accompanies patients to the clinic to ease the process.
Florence Khoza, another traditional healer involved in the initiative, highlighted the risky sexual behaviors prevalent in the community. While she has long dispensed traditional herbs to treat sexually transmitted infections like gonorrhea, she now also encourages patients to test for HIV. “I tell them it is in their best interest,” Khoza said. She noted that many patients fear being seen at clinics collecting HIV treatment. In such cases, she collects the medication on their behalf.
Researchers hope the success of this program will prompt the South African government to roll out similar training nationwide. By integrating traditional healers into the public health framework, the initiative aims to reduce stigma, improve HIV testing rates, and ultimately decrease new HIV infections across rural South Africa.