Matsavana

Researchers are evaluating an expanded Healer-Initiated HIV Testing and Linkage to Care intervention in rural South Africa to address gaps in regular HIV testing. This cluster randomized controlled trial compares standard HIV testing programs with enhanced testing and support provided by traditional healers, aiming to reach populations less likely to test due to social and systemic barriers. The study builds on a successful pilot where traditional healers offered counseling and testing, including partner-based and community outreach testing, to improve HIV testing rates and linkage to care. The trial involves 42 clinical catchment areas randomly assigned to either standard care or the intervention where traditional healers provide HIV counseling and testing services to their clients. Healers will advertise free testing, offer partner testing at their facilities or client homes, and hold monthly community outreach events. They also support linkage to care by accompanying clients to clinical appointments and providing ongoing adherence counseling via in-person visits or WhatsApp, with additional nurse support through a group chat. Participants will be community members aged 18 and older who choose to receive HIV testing from traditional healers or through standard programs. The study will monitor HIV testing uptake over 24 months, assess implementation and maintenance of healer-initiated testing, and evaluate cost-effectiveness compared to standard care. Data collection includes rates of testing and linkage to care, with ongoing monitoring to support adherence and engagement throughout the studys duration.