Traditional health practitioners’ management of HIV/AIDS in rural South Africa in the era of widespread antiretroviral therapy

Zuma, T., Wight, D. , Rochat, T. and Moshabela, M. (2017) Traditional health practitioners’ management of HIV/AIDS in rural South Africa in the era of widespread antiretroviral therapy. Global Health Action, 10(1), 1352210. (doi: 10.1080/16549716.2017.1352210) (PMID:28771116) (PMCID:PMC5645651)

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Abstract

Background: Traditional health practitioners (THPs) have been identified as a key local resource in the fight against HIV/AIDS in South Africa. However, their approaches to the treatment of people living with HIV (PLHIV) have been met with skepticism by some biomedical practitioners amidst increasing access to antiretroviral treatment (ART). In light of this ambivalence, this study aims to document and identify treatment approaches of THPs to the management of illness among PLHIV in the current era of widespread access to ART. Methods: The study was conducted as part of a larger trial of treatment as prevention (TasP) in rural northern Kwa-Zulu Natal, intended to treat PLHIV regardless of CD4 count. Nine THPs were enrolled using purposive and snowballing techniques. Repeat group discussions, triangulated with community walks and photo-voice techniques were conducted. A thematic analysis approach was used to analyse the data. Results: Eight of the nine THPs had received training in biomedical aspects of HIV. THPs showed a multilayered decision-making process in managing illness among PLHIV, influenced by attributes and choices of the THPs. THPs assessed and managed illness among PLHIV based on THP training in HIV/AIDS, THP type, as well as knowledge and experience in the traditional healing practice. Management of illness depended on the patients’ report of their HIV status or willingness to test for HIV. Conclusions: THPs’ approaches to illness in PLHIV appear to be shifting in light of increasing exposure to HIV/AIDS-related information. Importantly, disclosure of HIV status plays a major role in THPs’ management of illness among PLHIV, as well as linkage to HIV testing and care for their patients. Therefore, THPs can potentially enhance further success of antiretroviral therapy for PLHIV when HIV status is known.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wight, Professor Danny
Authors: Zuma, T., Wight, D., Rochat, T., and Moshabela, M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Global Health Action
Publisher:Taylor and Francis
ISSN:1654-9716
ISSN (Online):1654-9880
Published Online:03 August 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Global Health Action 10(1): 1352210
Publisher Policy:Reproduced under a Creative Commons license

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727661SPHSU Core Renewal: Complexity in Health Improvement Research ProgrammeLaurence MooreMedical Research Council (MRC)MC_UU_12017/14IHW - MRC/CSO SPHU