South Africa is currently facing one of the most severe HIV/AIDS epidemics worldwide, with almost 1,000 AIDS deaths occurring every day. Various factors have been blamed for the rapid rise of the epidemic, one of which relates to people’s overall ignorance about the disease, this is closely linked to people’s outlook on HIV testing.

75 km from Zeerust and Mafikeng is the Ntsweletsoku village, located in the most HIV infected area within the North West Province. Both lack of knowledge and the stigma associated with HIV/AIDS account for the high prevalence found within this particular village.

Members of the Ntsweletsoku village community work in the nearby mines as civil servants, and often come home sick from AIDS related diseases that threaten the very fabric of life for the whole community. The literacy level is fairly low and the standard of living is barely improved by families’ reliance on the child-support grant and old age pension.

In September 2005, in response to the spread of HIV/AIDS within this particular village, the local NGO Tlhoafalo Advice Centre implemented a voluntary counselling and testing programme.

Introducing Voluntary Counselling and Testing (VCT)

Innocent Motlhope, a community member of Ntsweletsoku village contends that, ”HIV/AIDS was like a myth before Tlhoafalo Advice Centre came to the village.” Prior to the implementation of the programme by the NGO, information about HIV was not readily available, and where it was available it was often incorrect.

Motlhope is of the view that, “The programme helped to raise awareness about the epidemic and has helped to deepen people’s understanding about the disease.” 

Though other civil society organisations have attempted to get the message across to the community members through the aid of information desks, the community was not receptive. It soon became evident that they preferred to remain ignorant than to be associated with the disease.

Reasons for the High HIV Prevalence Rate

Botshelo Segaetsho, a community member states that, “The youth of Ntsweletsoku village are at high risk of contracting the virus because most of them are unemployed and engage in unprotected sex in order to have more babies to enable them to access child grants.”

Raisibe Tshweu, the Co-ordinator for the Tlhoafalo Advice Centre argues that the programme was launched in response to this worrying phenomenon. ”We identified the village because we were worried about the rate of high school pregnancies and the fact that this trend is closely connected to the spread of HIV/AIDS.” 

Segaetsho maintains that, “It is very common here to find a young woman of 21 years having about five children and this is the main reason why the village has a high rate of infection.”

Challenges for VCT

Grace Zim, a community member, states that the route that the centre has embarked upon is very challenging in light of the fact that, “It is difficult to encourage people to commit to a voluntary test because of the stigma attached to the epidemic.”

A regional study, conducted in 2005, suggests that men are less likely to access VCT services than women. The researchers argued that most men saw the disclosure of their status as a burden that brought with it stigmatisation. 

In a bid to help in the fight against the stigma associated with HIV/AIDS within the village, the local chief recently announced the establishment of the centre and explained its benefit to the community at large. Segaetsho argues that he would like to see more traditional leaders actively involved in the fights against AIDS because, “Their influence may help encourage community members to go for testing.”

Since its inception in September last year, the programme has had a significant impact on the community. Despite the challenges that the programme has had to contend with in the village, voluntary testing in the village is on the increase, with at least 13 people getting tested weekly. “However, the numbers are still not up to the desired levels,” states Tshweu.

Tshweu suspects that the people of the community are still not comfortable with knowing their status. She maintains that most people think that, “Once you know your status you will die quickly.”

In response to this issue, the centre has embarked on a door-to-door campaign, where the counsellors provide counselling for HIV infected people at their own homes. The aim of the exercise is to educate the community about the dangers of having unprotected sex and multiple partners.  

Slow and Sure Progress

Though the centre is yet to have a rapid influx of people coming forward for voluntary testing, the community is positive about the work that Tlhoafalo Advice Centre has done thus far.

Zim asserts that, “The centre has helped us in many ways and has managed to change the community’s thinking when it comes to HIV/AIDS and knowing your status.”

– Badumile Duma and Butjwana Seokoma, SANGONeT Information Coordinators