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AIDS: Rural Areas, Stigma, and VCT
30 March 2009

Israel Ndlovu, of Pietermaritzburg, South Africa, contributes the following out of the experiences of the ESSA Christian AIDS Program (ECAP).

In rural areas, many still believe that there is no AIDS. Many are bound by witchcraft. If a person is sick they believe that a spell has been cast upon them. HIV and AIDS is a complex problem with devastating effects on communities and families worldwide. Each country requires many tools in order to turn the tide of this epidemic. Voluntary Counseling and Testing (VCT) is a tool for primary prevention intervention. It can serve as an entry to care and support services for infected persons.

We are working with the caregivers in rural areas, visiting terminally ill patients in their homes. They share their difficulties in accessing VCT programs. In these areas, people living with HIV and AIDS (PLWHA) find it difficult to disclose their status to family members because of the stigma. It is difficult to visit VCT sites for post-test counseling for fear of being seen and stigmatized by community members who lack information and education on HIV and AIDS. Even in social gatherings like wedding parties and funerals, PLWHA may be prevented from participating in some capacity—for example, preparing food. It may be difficult to set up support groups. PLWHA need help with disclosure and adherence in medication.

Community outreach in our setting involves educating families about HIV and AIDS, providing information for PLWHA on steps to disclosure, and journeying with them in this process. It includes visiting the terminally ill—which may include counseling, bathing, discussing the future of the patients and their children, sorting out the burial schemes, and supplying most needed resources like disposable nappies, mouth-wash, medicine, and linen-savers. Community outreach is at the heart of our activities.

Lessons Learned

Successful community-based programs addressing stigma and discrimination:

  • Begin small and grow slowly as the needs and resources of the community grow and change.
  • Involve people from the community in each stage of the work—from planning to implementation to evaluation.
  • Engage leaders whose main interest is serving the community, not advancing their careers or making money.
  • Are facilitated by people who are open to new ideas and adapt to the changing needs of those served by the project.
  • Are holistic, not thinking about health just in terms of prevention and treatment of the disease, but of each person’s social, emotional, and physical situation.

Community outreach and community mobilization work is strengthened by using advocacy, lobbying, policy and legal frameworks, promoting human rights and literacy, running workshops to raise awareness, and partnering with influential institutions.

Pray

Pray for HOPE for AIDS South Africa as they continue the ECAP Program. That God would reveal himself in a clear way to the people living with HIV and AIDS.

Give

If you would like to give a gift to help PLWHA in South Africa, please consider the Duduza Home or Project Positive Ray.

Go

Check out the opportunities to serve with SIM in South Africa!

Comment on this post: Email international.aids-consultant@sim.org
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