In South Africa, healers are joining the fight against HIV despite the stigma that persists in rural areas.

BUSHBUCKRIDGE, South Africa (AP) — The walls of Shadrack Mashabane’s hut in the rural South African town of Bushbuckridge are covered in traditional fabrics and a small window is the only source of natural light. Among the herbs and medicines stored in glass bottles, a white box containing an HIV test kit stands out.

Mashabane is one of at least 15 traditional healers in the city who, as part of a pilot project, have been trained by University of the Witwatersrand researchers to provide HIV testing and counseling to reach as many people as possible in the South. Africans can find out their serostatus.

The measure is part of the nation’s largest known initiative to involve healers in addressing public health issues and studying outcomes. By the end of this year, at least 325 more healers will have completed the process and become certified HIV counselors. The researchers will compare testing rates between healers and clinics.

According to the researchers, most of them already knew about HIV, some from personal experience, and were ready to participate in the project.

South Africa has one of the highest HIV rates in the world. In many communities, stigma around the disease and its treatment persists, even though retroviral medications and pre-exposure prophylaxis are free. Concerns about confidentiality in clinics also prevent many from seeking help.

Many villagers consider healers their first point of contact when sick, and the project hopes they will help change attitudes.

The country’s huge young population is of particular concern. A government study published in December found that the percentage of the population living with HIV fell from 14% in 2017 to 12.7% in 2022, but the prevalence has increased among girls aged 15 to 19, a phenomenon attributed to mostly relationships with older men.

Bushbuckridge, a town in Mpumalanga with a population of about 750,000, has about 2,000 healers providing traditional and spiritual services.

Mashabane said his patients initially found it difficult to believe he was offering them HIV testing, which had long been available only in clinics.

“Many people were not convinced. I had to show them my certificate to prove my qualifications,” he said.

The process involves signing consent forms for testing, as well as follow-up with Mashabane to ensure patients who test positive receive treatment at a local clinic.

Breaking the news to a patient that he is suffering from this disease is not very difficult since it is a pathology that can be treated with readily available drugs, he noted. But in many cases he has to accompany them to the clinic “to make it easier for them.”

Florence Khoza is another healer trained in HIV testing. He noted that risky sexual practices are common and that he usually prescribes herbs and traditional medicines to treat gonorrhea, but he is now going further and advising his patients to get tested.

“I tell them it’s for their own good,” he said.

According to Khoza, many patients are afraid to go to a clinic or hospital and fear that other members of the community will see them receiving treatment, so “in many cases, I obtain HIV medications on their behalf.”

Ryan Wagner, the study’s lead researcher, said testing and treatment by traditional health professionals could “ultimately lead to an end to new cases in communities like those in rural Mpumalanga, which has some of the highest rates of HIV in the world.”

The researchers hope their findings will inspire the South African government to launch a nationwide training program.

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