# Traditional healer-initiated HIV counseling and testing in rural South Africa

> **NIH NIH R34** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2022 · $188,566

## Abstract

Project Summary
In South Africa, HIV testing has been undermined by HIV stigma, distrust in the allopathic health system, a
preference for traditional medicine, and distance to the health facility. South Africa has made progress towards
their 90-90-90 goals, yet a substantial proportion of the population do not test regularly; only 33.9% of adults in
rural Mpumalanga (our study site) underwent HIV testing in the past year. In South Africa, people of low
socioeconomic status (SES), men, immigrants, and those who distrust the health system have higher rates of
HIV stigma, are more likely to seek care from traditional healers, and are less likely to receive an HIV test. The
demographic and sociological characteristics of healers closely mirror this population, making them an ideal
group to bridge the health care utilization divide.
 Development of a Healer-Clinician HIV Prevention Collaborative will facilitate testing and preventive
service linkage among those who have traditionally avoided/refused testing via three synergistic strategies: (1)
Healer-Initiated Counseling and Testing (HICT) to reinforce the value of HIV testing and teach HIV stigma
reduction and coping strategies; (2) Establishing a path for patients to navigate between traditional and allopathic
systems to encourage repeat HIV testing (or treatment, if HIV-positive); and (3) Improving the environment at
the health facility via a stigma reduction training and “open house” sessions where healers and providers work
together to provide patients an opportunity to better understand health services (and increase the likelihood that
patients return). We propose to pilot this novel intervention with patients seeking treatment from a select group
of trained traditional healers. We hypothesize that patient's seeking traditional treatment will find the offer of
testing acceptable, will uptake HIV testing despite high levels of stigma and mistrust of the health system, and
will engage in treatment at the health facility after linkage by their traditional healer.
 The Specific Aims of this study are to: (1) Conduct qualitative interviews with “non-testers” from varied
SES and demographic groups to understand the interface of HIV stigma, mistrust in the health system, and HIV
testing to create the most acceptable model of healer-based testing; (2) Adapt a successful South African
community-based HIV prevention project to create a Healer-Clinician HIV Testing and Prevention Collaborative;
and (3) Pilot our Healer-Clinician Collaborative and assess uptake of HIV testing as well as linkage to treatment
and prevention services among participants offered healer-initiated counseling and testing. Our team has a
proven record of engaging traditional healers to improve patient outcomes, conducting research to evaluate and
address mistrust in the health system, HIV stigma, and developing interventions to increase HIV testing uptake.

## Key facts

- **NIH application ID:** 10319631
- **Project number:** 5R34MH124496-02
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Carolyn Audet
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $188,566
- **Award type:** 5
- **Project period:** 2021-01-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10319631

## Citation

> US National Institutes of Health, RePORTER application 10319631, Traditional healer-initiated HIV counseling and testing in rural South Africa (5R34MH124496-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10319631. Licensed CC0.

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