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HORIZONS PROJECT
Evaluating the Carletonville STD/HIV Project
The Horizons program, in collaboration with the Council for Scientific and Industrial Research, the South Africa Institute for Medical Research, and the London School of Economics and Political Science, conducted an intervention study (formally titled "Operations Research in the Carletonville STD/HIV Project: Evaluating a Combination of Strengthened STD Service Delivery and HIV/STD Prevention and Selective Presumptive Treatment") in the Carletonville mining town to study the social determinants of the HIV epidemic and to assess the impact of a targeted program of HIV and sexually transmitted infection (STI) prevention and service delivery.
During the study period, the intervention targeted mainly sex workers and miners, groups perceived to be at high risk. The aims were to reduce the prevalence of STIs, increase condom use, and decrease sexual partner change among these groups in the Carletonville area. A key objective of the study was to assess the impact on the larger community of the program targeted to mine workers and sex workers. Three key interventions were implemented: behavior change communication, condom promotion, and STI management.
Results from the study were mixed:
- Knowledge of HIV transmission increased.
- While mine workers reported a decrease in number of casual partners, community members reported an increase.
- Condom use with casual partners increased among mine workers and slightly among community members, but remained unchanged among sex workers.
- Condom use with regular partners among sex workers decreased. Consistent condom use with regular partners in the community remained low.
- STI and HIV prevalence among the targeted groups and the community remained constant or increased slightly.
This study showed that in order to have an impact on behavior change and STI and HIV infection in the community, the intervention needs to be refined, as indicated by the following recommendations:
- Extend the peer education program to reach women who practice sex work informally and do not self-identify as sex workers.
- Address the issue of condom use with regular partners and spouses more directly as part of peer education and condom promotion activities.
- Extend periodic presumptive STI treatment to cover other vulnerable groups in Carletonville, such as informal sex workers, who may be transmitting STIs to others within their sexual networks.
Location
Carletonville, South Africa
Duration
December 1998–December 2002
Horizons and Population Council researchers
Johannes van Dam, Lewis Ndhlovu, Catherine Searle
Non-Council collaborators
Dennis Dobbs (consultant)
Solly Moema, Yodwa Mzaidume, Bareng Rasego (Mothusimpilo Intervention Project)
Carletonville AIDS Action Committee
Council for Scientific and Industrial Research
Institut National de la Santé et de la Recherche Médicale
Progressus
London School of Economics and Political Science
South Africa Institute for Medical Research
Donors
US Agency for International Development
Council for Scientific and Industrial Research
Family Health International
Gauteng Department of Health
UK Department for International Development
Publications/Resources on this project
See Also
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Publications/Resources |
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"A targeted intervention falls short: Study in South African mining community highlights importance of understanding sexual networks" (2005) (full text) “Reducing the transmission of HIV and sexually transmitted infections in a mining community: Findings from the Carletonville Mothusimpilo intervention project: 1998 to 2001” (2005) (PDF) “Strengthening STI treatment and HIV prevention services in Carletonville, South Africa” (2004) (PDF) |