Moshabela M. auteur aut IRD Zuma T. auteur aut IRD Orne-Gliemann J. auteur aut IRD Iwuji C. auteur aut IRD Larmarange Joseph auteur aut IRD McGrath N. auteur aut IRD text journalArticle eng text/pdf born digital access The ANRS 12249 Treatment-as-Prevention (TasP) cluster-randomized trial in rural South Africa uses a test and treat approach. Home-based testing services and antiretroviral treatment initiation satellite clinics were implemented in every cluster as part of the trial. A social science research agenda was nested within TasP with the aim of understanding the social, economic and contextual factors that affect individuals, households, communities and health systems with respect to TasP. Considering the rural nature of the trial setting, we sought to understand community perceptions and experiences of the TasP Trial interventions as seen through the eyes of traditional health practitioners (THPs). A qualitative study design was adopted using four repeat focus group discussions conducted with nine THPs, combined with community walks and photo-voice techniques, over a period of 18 months. A descriptive, interpretive and explanatory approach to analysis was adopted. Findings indicate that THPs engaged with the home-based testing services and HIV clinics established for TasP. Specifically, home-based testing services were perceived as relatively successful in increasing access to HIV testing. A major gap observed by THPs was linkage to HIV clinics. Most of their clients, and some of the THPs themselves, found it difficult to use HIV clinics due to fear of labelling, stigma and discrimination, and the ensuing personal implications of unsolicited disclosure. On the one hand, a growing number of patients diagnosed with HIV have found sanctuary with THPs as alternatives to clinics. On the other hand, THPs in turn have been struggling to channel patients suspected of HIV into clinics through referrals. Therefore, acceptability of the TasP test and treat approach by THPs is a major boost to the intervention, but further success can be achieved through strengthened ties with communities to combat stigma and effectively link patients into HIV care, including partnerships with THPs themselves. specialized HIV testing antiretroviral treatment treatment-as-prevention traditional healers HIV stigma South Africa AFRIQUE DU SUD 056 108 28 3 24-32 2016 0954-0121 https://www.documentation.ird.fr/hor/fdi:010067745 10.1080/09540121.2016.1181296 0954-0121 [F B010067745] https://www.documentation.ird.fr/hor/fdi:010067745 https://www.documentation.ird.fr/intranet/publi/2016/09/010067745.pdf Accès réservé (Intranet de l'IRD) IRD - Base Horizon / Pleins textes 2016-09-30 2022-12-08 fdi:010067745 fre