By Inside Education reporter
A US funded grant of nearly $3 million from the National Institutes of Health to Wits and Vanderbilt
University will advance traditional health practitioner-initiated HIV testing.
The grant that sets the foundation for traditional healers to be trained to initiate HIV counselling,
testing, and linkage to care in Bushbuckridge, Mpumalanga builds on the success of a study called
Know Your Status.
The research for the study is located at the MRC/Wits Rural Public Health and Health Transitions
Research Unit (Agincourt), a research unit in Bushbuckridge, Mpumalanga and runs under the
auspices of the Wits School of Public Health, in partnership with the Vanderbilt Institute for Global
Health (VIGH) in the US.
Dr Ryan Wagner, senior research fellow at Agincourt and co-principal investigator, with Carolyn
Audet, associate professor of health policy, and VIGH principal investigator, lead the study.
The study will compare rates of HIV testing in traditional healer trained HIV counselling and testing
communities versus control communities in a cluster randomised controlled trial in 42 clinical
catchment areas.
The traditional healer practitioners will advertise and offer free testing to their clients and clients’
partners, and take part in monthly local, community-based testing outreach activities at local events.
In addition to offering testing, the trained traditional healers will further support their clients who
test positive by accompanying them to the department of health (DoH) clinics for counselling and
antiretroviral therapy (ART), and ensure that their clients regularly take their ART.
While South Africa has made progress in reaching the United Nations’ 95-95-95 targets – (95% of
people living with HIV knowing their status, 95% of people receiving care after diagnosis, and 95% of
people achieving viral load suppression while being treated) – people of low socio-economic status,
males and those in rural areas do not test regularly.
But these groups are more likely to seek care from traditional healers making this sector ideal
practitioners to enable diagnosis and aftercare, if required.
This expanded research project is a collaboration between Wits’ Agincourt, Vanderbilt, the South
African Department of Health (DoH), and Kukula, the local traditional health practitioners’
organisation.
It is part of Ntirhisano (meaning ‘working together’ in the local xiTsonga language), a larger portfolio
of work that explores ways of engaging traditional healers to strengthen the primary health care
system.
The study seeks to evaluate the effectiveness, incremental costs, and results of the intervention and
control sites, including clinical and economic outcomes, with the goal of providing evidence to the
DoH for longer term sustainability and uptake.
“The Know your Status is an extremely innovative and important study, which offers the possibility
of targeting HIV counselling, testing and ART to those who don’t regularly access clinics. Targeting,
testing, and treating via traditional health 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,” said Wagner.
Reflecting on the wider application of the work, Audet said, “If traditional healers can be trained to
conduct testing, informal community leaders in the U.S. can potentially join forces to reach those at
the highest risk of HIV acquisition. Barbers, religious leaders, and teachers are examples of trusted
members within communities.”
This research is funded by the National Institute of Mental Health (R01MH135738), an Institute of the U.S.
National Institutes of Health. Vanderbilt University and Wits University are Strategic Partners. To learn more
about this study and the larger Ntirhisano portfolio of work, visit: www.wits.ac.za/ntirhisano.
