Includes bibliographical references (leaves 90-93).There are few studies on the impact of African traditional healing on HIV/AIDS care and treatment in South Africa. There is a need for concrete data on the subject as many people across the African continent are thought to be accessing these kinds of healing services. This study which consists of three inter-related sub studies, investigated the impact of African traditional healers on Antiretroviral (ARV) treatment in South Africa. Each of the sub studies focused on the insights and opinions of three different populations, i.e. health care workers, traditional healers (who were affiliated with HIV/AIDS care services) and HIV positive patients. The first of the sub studies used in- depth interviews to explore the attitudes and approaches often health care professionals (nurses, doctors, ARV counsellors and a pharmacy assistant) working in ARV roll out sites in South Africa to their patients taking traditional medicine and accessing traditional healing paradigms. The sub study also probed their opinions of collaborating with traditional healers to strengthen ARV care. Furthermore, this sub study included two focus group discussions with lay health workers at two ARV sites (i.e. ARV counsellors and patient advocates). On the whole the study showed that health care professionals are concerned about the possibility of traditional healers undermining an ARV roll out programme. These perceptions are based on concerns that traditional healers may provide untested substances to HIV positive patients that could interact adversely with ARV drugs. They also believed that traditional healers could discourage patients from adhering to their ARV regimen. However, despite these concerns, most of the health care professionals were willing to collaborate with traditional healers but the partnership would have to be formed on the basis of the principles of the biomedical paradigm of healing. Health care professionals preferred to be solely in charge of the ARV drug regimen with (biomedically) trained traditional healers supporting them. They preferred traditional healers to concentrate solely on symbolic rituals. The focus groups with the ARV counsellors and patient advocates show that these lay health workers support an ARV roll out process that effectively underplays the role of traditional healers and therefore actively discourage their patients from using traditional healing services while taking ARV treatment. The second sub study complements the first and used in-depth interviews to explore the attitudes and approaches of five female traditional healers (working in HIV/AIDS organizations in the Western Cape) towards the use of ARV treatment by their clients. This study also explored their attitudes towards a partnership with the formal public health sector with regard to HIV/ AIDS care. The sub study showed that traditional healers are concerned about the wellbeing of HIV positive people. All of the traditional healers who were recruited into this study were in favour of a partnership with health care workers as long as such a partnership is based on mutual collaboration and respect. The third sub study was a study of HIV positive patients attending health facilities that provide ARV care. A semi structured questionnaire was adapted from instruments used in previous studies and was complemented by in depth interviews with patients who reported use of traditional healing systems in the past year. This sub study explored the attitudes of the respondents towards African traditional healers and their practices. The responses of the patients show that the majority of respondents have never accessed a traditional healing service. Some of the patients recruited in the study said they had accessed a traditional healing service before they had begun ARV treatment or before they were recruited into this study. They expressed the reasons for their choice. Only two patients were found to be actively crossing between ARV treatment facilities and traditional healing services at the time of their interview. A public health and human rights analysis suggests means of incorporating a traditional healer in ARV care, whereby an ARV treatment policy can respect cultural rights of patients and traditional healers while simultaneously improving ARV treatment infrastructure. Limitations encountered in the study such as location of the research sites, nature of the respondents and the ways in which the questions were worded to the respondents were addressed through efforts by the researcher. The study concludes that a partnership between traditional healers and the formal public health sector is feasible but must incorporate respect for cultural rights
