South Africa

HIV/AIDS Prevention Program

Recently, the United Nations lowered its estimate of the number of people infected with HIV/AIDS in sub-Sahara Africa to 25 million, or 60 percent of the worldwide total.   However, the HIV/AIDS pandemic continues to worsen in South Africa despite many active, well-financed prevention efforts.  By the end of 2008, one on five adults were infected with HIV/AIDS, over five million people were living with HIV, and there were almost 1,000 AIDS deaths per day.  Among those ages 15-49, a staggering 71 percent of all deaths are caused by AIDS. 

Recognizing the need for an entirely new approach to slow down the HIV/AIDS epidemic in South Africa, in 2008 DKT began designing a completely new kind of communications program among Xhosa-speaking townships in Western Cape Province.  This project is directed by John A. Harris, who has 12 years of experience designing and managing behavior-change communications projects in eight African countries. 

DKT has chosen Xhosa sites because they have a high incidence of HIV/AIDS and yet are underserved by existing HIV/AIDS prevention programs.  In addition, access to service is further limited because providers do not in general speak Xhosa.

Throughout Africa, small-group discussions led by local activists are considered the most powerful method for changing HIV/AIDS-related behaviors.  This approach has largely been responsible for Uganda’s success in reducing the incidence HIV/AIDS.  Thus far, however, this approach has not taken hold in South Africa.

In Western Cape Province, DKT is fielding a team of Xhosa-speaking promoters trained to use local interpersonal networks and intensive in-home discussions to motivate and empower people to take concrete and effective action to protect themselves and their communities from HIV/AIDS.  DKT estimates that 50 effectively trained field workers could reach 500,000 people over a two-year period at a cost per person of less than one US dollar.

The goal of DKT’s South Africa program is to increase self-reported risk reduction practices and reduce the incidence of HIV/AIDS.  A control population will be used for comparison.  DKT anticipates that by the end of three years, at least one major element of the project will be ready for replication elsewhere in South Africa.