If the new initiative by Population Services International (PSI), a social marketing non-governmental organisation (NGO), works, it may bring about the breakthrough in behaviour change that health groups have sought for so long.  

Getting individuals to test is hard enough: the government estimates that only one in five people in Swaziland know their status. “When both partners are educated about HIV at the same time, they tend to work together on changing their behaviour, like using condoms,” said Sam Vilakati, a testing and counselling officer in Mbabane, the capital.  

“The ‘holy grail’ of AIDS eradication in Swaziland has always been getting people to embrace responsible sexual activity; that is more likely to happen if partners are equally informed and involved.”  

Vilakati is among the thousands of healthcare professionals in Swaziland who have watched HIV/AIDS initiatives come and go without denting the HIV prevalence rate of around a quarter of all sexually active adults.  

The solution offered by the Love Test seems simple, but requires careful manoeuvring through the minefield of behaviour change. “We had a problem with people testing alone – they would be counselled and know all about how to live with HIV,” said Sipho Dlamini, a brand manager at PSI Swaziland.  

“But when they went home, their partners would not have been counselled, and when they heard the news they would react with fear and rejection. This led to a lot of people afraid to disclose to their partners, and this helped fuel the epidemic.”  

In the Love Test project, couples act together. “After testing, the couples immediately go into a counselling session together, where they are presented with a risk reduction strategy and a positive living strategy,” Dlamini said.  

The Ministry of Health, the National Emergency Response Committee on HIV/AIDS, the UN Children’s Fund (UNICEF) and UNAIDS have all partnered in the initiative, which combines public awareness with clinical testing and counselling.  

PSI hired leading advertising agencies to interest the public with compelling ad campaigns. As a result, individuals and their partners are turning up at PSI’s nine clinics, located mostly in urban and peri-urban areas, as well as at government and private clinics.  

“Couples don’t often get tested together, and individuals who have tested have been 65 percent female and only 35 percent male. Before the Love Test campaign, only 2 percent of people tested did so as couples,” said Dlamini.  

Dominique Neil, Media Technical Advisor for PSI Swaziland, said the name ‘Love Test’ was chosen because it speaks of mutual devotion and respect. But in a patriarchal society like Swaziland, where gender equality is a new concept and often disdained by traditionalists, such an approach can be controversial.  

“In our poster we have a drawing of a man kneeling before a woman, like he is proposing marriage. Some of our Swazi partners worried about this – ‘Why is this Swazi man kneeling in front of a woman?’ they ask. We are projecting that 40 percent of people tested for HIV do so as couples. That is the goal that will say our strategy has worked,” Dlamini commented.  

Neil said, “We started [testing] in April, after regional awareness campaigns in the four regions of Swaziland. [Overall,] testing doubled in April and May, and [the number] of couples getting testing has tripled.”  

PSI has a presence throughout Southern Africa, and other nations are watching the initiative with interest. “It’s caused quite a stir with all our partners in the [Southern African] region. They’re thinking of adapting it to their countries,” said Dlamini.  

IRIN/PlusNews spoke to Janice and Sipho, a couple waiting for their Love Test at a clinic in Mbabane. Although they admitted to being nervous at the prospect of an HIV-positive result, they were convinced they were doing the right thing.  

“We know we should test, like everyone,” said Janice. “I was scared, and so was Sipho – it is easier that we do this together.”

This feature is used with permission from IRIN/PlusNews  –  www.plusnews.org