Community experiences of ART: Community experiences of ART: challenging assumptionschallenging assumptions

IDRC Satellite session13 August 2006

Ari Ho-Foster

CIETinternational

What is CIET?What is CIET?

• International post-graduate institutes • Group of not-for-profit organisations• Experience in 50+ countries worldwide• In South Africa since 1997

• Three cycles of data collection and feedback on community views of ART in Free State

QuestionsQuestions

• What contribution can research offer to ART rollout?

• How can research contribute to building public spaces for innovation, experimentation and detecting and correcting ‘failures’ or mistakes?

Competing priorities Competing priorities

1 in 4 not enough to eat in past week1 in 6 with someone too ill to go to

health facilitiesHalf of heads unemployed, and one-

third below poverty line

FS/SW/LS: More immediate threats to health mentioned as priorities

Health Systems are complexHealth Systems are complex

• Communities use service providers from the public, private and/or traditional sectors• One half of respondents personally attended

government health facility• 1 in 5 consulted private services• 1 in 10 used a traditional healer• Commonest source of info is mass media

• Messages and treatments can conflict

Community understanding of HIVCommunity understanding of HIV

• Less than half gave allopathic explanation for cause of AIDS

• 1 in 4 didn’t know there wasn’t a cure

• Ensuring discussion /socialisation among marginalised populations• Older groups• Less educated• Impoverished• Gender differences

Support for testingSupport for testing

• 4 in every 5 knew where to get tested • 3 in 4 had not been tested • Over half did not plan to get tested

• 3 in 5 believed others in their community would care for someone who is HIV positive

Community perspective of ARTsCommunity perspective of ARTs

Less than one half had heard of ARTs

• 2 in 5 knew when to seek treatment, but

• 4 in 5 believed ART is effective• 4% would not advise someone with AIDS

to take ARTs

• 1 in 10 thought people in their community did not believe ART could help someone with AIDS

Nurturing public spaces for innovationNurturing public spaces for innovation

• Directing research towards informing policy and planning

• Appropriate public information on ART

• Communicating research findings to both service providers and ultimate beneficiaries

• Donor to advocate for and fund activities in research proposals to do this

Can we assume…Can we assume…

• Equitable intention means equitable uptake?• There will be a supportive environment for

those who do take up ART?• Providing information means that people

understand or agree (RCT)?• No public information means less demand?• Can we even talk about rollout without

community buy-in?

For more information, visit: www.ciet.org