Our staff recently underwent a process of counselling and voluntary testing for HIV, which served to illustrate a number of important points about practising what one teaches. Being an HIV prevention programme, one of our main goals is to raise awareness in our participants – especially the teenagers in our high school programme – of the importance of knowing their HIV status. We assume that having been given basic information about the virus and the AIDS epidemic, and some encouragement to test, our participants will eagerly rush to the nearest health centre to get tested. However, our experience with our own staff – the coaches and area coordinators who teach at our sites as well as their managers – has shown that testing for HIV can often be difficult even for those who know the benefits of it well.
The process of testing our staff, a service provided free of charge by a health services company, kicked off with an education session facilitated by a very capable educator. The session covered topics such as the structure of the HI virus, transmission, stigma and issues of testing and disclosure. So good was this session that some members of staff were inspired to go and test for HIV without even waiting for the group testing session that followed. When it came time for all staff to receive counselling and testing, 80% (32 out of 40) of staff members arrived. All 40 had previously confirmed they would be available. Of the 20% that were not able to attend, some had strong and understandable reasons not to, while others were less convincing. Of the 80% who tested, 13% (4 out of 32) opted not to test after having undergone counselling. This, of course, is quite acceptable as the testing is purely voluntary. However, both the decision not to test and avoiding the process altogether by some of our staff demonstrated that a significant level of discomfort with the process can exist even for those who know well why they need to undergo it.
On the other hand, conversations with those who did test pointed to the benefits of the exercise. In the first instance, staff members felt good or relieved to know their status. While they all knew they needed to, very few had actually bothered to get themselves tested. Many staff members also felt the exercise had equipped them with firsthand experience they could share during their education sessions. Others expressed the view that their own fears of going through the process had given them new insight into why people who know the benefits of testing for HIV, and the dangers of not testing, still failed to do so. One coach confided that she now had empathy with people in this position, whom she had previously judged to be reckless and irresponsible.
This entire experience presents some important lessons for those of us concerned with HIV/AIDS prevention, especially in South Africa:
- The subject of HIV is still taboo and difficult to feel comfortable about;
- Knowledge of the need and benefits of testing alone is not enough to make people get tested - other factors like support and the right environment also count;
- People respond differently to the message of HIV testing, and may be ready to go ahead with it at different times;
- It is important for us educators to undergo the process ourselves first before we can seek to convince others to do so, so that we may better understand any issues they may have that make them resistant to testing. The old adage stays true – we must practise what we preach.
PeacePlayers International – South Africa