KHOPOTSO: From seeing a mere 200 clients when it started two years ago, New Start now has about 5 000 people coming in for an HIV test every month. More than half or 51% of these are men, while the rest are women and couples coming to test together. Attracting a steady increase of men to test is no mean feat. Scott Billy is Technical Advisor at the Society for Family Health (SFH), a not-for-gain company which developed the New Start programme.

SCOTT BILLY: We were asked by government to develop a programme for HIV testing that would complement what they are doing. The government of South Africa has, in my opinion, really good HIV testing programmes’€¦ But if you go to a government clinic, you’€™ll see they test mostly women and very sick people. Men are not getting tested and couples are not getting tested at government services. So, we developed New Start to appeal to people least likely to go to a government testing service, namely to men and to couples. About 10% of our clients come in as a couple and 51% of our clients are men. And if you look at the testing rates, men are far less likely to have been tested than women.

KHOPOTSO: A majority of social scientists and health care providers working in the public health service often speak of the ‘€œunwillingness’€ of most men to test for HIV. Observations show that only a quarter of people using government testing services are men. Billy concedes that that is a problem. But what is it that New Start is doing differently?      

SCOTT BILLY: I think men do want to get tested. What we’€™ve found through our own research is that two things are really important to men. One is convenience, and the other is anonymity. I think if you can provide a service that’€™s anonymous and confidential, and if you can provide a service that’€™s really convenient – because men don’€™t want to go to a clinic – but if you can set up a mobile service in a train station or in a shopping mall and men are walking by, they’€™ll stop to get tested.    

KHOPOTSO: Marketing Manager for the Society for Family Health, David Nowitz, adds.

DAVID NOWITZ: It’€™s just that our marketing campaign is targeted at men rather than at women because, naturally, women seem to be going to testing centres because they’€™re pregnant and they have to know their status, etc. Men don’€™t have pregnancy issues, etc.

So, the only thing that really drives men for testing seems to be life insurance type things. But with us, we target our campaigns at men and that’€™s why we pick up more men.

KHOPOTSO: New Start has established centres in Durban, Cape Town as well as Johannesburg, and has recently opened two facilities in Bloemfontein, and Musina. These are supported by mobile testing services in public spaces such as taxi ranks and shopping centres. An hour-long service of pre and post-counselling, an HIV test and receipt of results costs R25. To maintain anonymity and confidentiality, clients don’€™t have to give out any identifying information.

Although it’€™s becoming a successful HIV testing brand, New Start is aware that it has a short-coming   similar to that of many developmental programmes ‘€“ failing to reach rural people. Scott Billy.

SCOTT BILLY: We’€™ve done a very bad job reaching rural communities. We’€™ve gone out a few times to reach rural communities, but we haven’€™t gone out enough. So, one new development is that we will be developing six new New Start services throughout the country and they will focus on what are called ‘€œpresidential nodes’€, and these are areas which are primarily rural areas, which have been designated by the Department of Health as being high (HIV) transmission areas, but also having a lack of services.

KHOPOTSO: Apart from running the HIV testing service, the Society for Family Health also distributes the government’€™s condoms, under the brand name ‘€œChoice’€. It also markets its own range of condoms ‘€“ ‘€œLovers’€™ Plus’€ and ‘€œTrust’€ – as well as ‘€œCare’€, a female condom. The organisation says it has now embarked on preliminary research to assess the South African man’€™s response to scientific news that male medical circumcision can have partial protection of about 60% against men acquiring HIV infection.

SCOTT BILLY: We hope that this research that we do will assist government as it develops its circumcision policy, and assist NGOs and other stakeholders as they determine what the country’€™s strategy should be for circumcision for HIV prevention… And what we’€™ve found out is that circumcision is (an) extremely complicated issue here in South Africa because there’€™s a mix of Western medical circumcision and traditional circumcision’€¦ When we say to people ‘€˜if you were told that circumcision can partially prevent HIV, would you be interested in the service’€™?… everybody says ‘€˜if you show us scientific proof that circumcision prevents HIV, then yes, we’€™d be very interested’€™.

KHOPOTSO: It would be interesting to see what the result is when the research is completed.