BOTSWANA: Tebelopele - contributing to HIV prevention

Gaborone, 12 November 2001 (PlusNews) - The waiting room of the Tebelopele Testing Centre in the Botswana capital Gabarone is covered in bright sunny yellow posters urging you to "know your status".

Staff at the centre mill about, making coffee and trying to make everyone feel comfortable. The four women who are waiting to be tested admit to feeling "nervous" and "scared".

Their reasons for coming are varied: one has seen numerous posters and billboards all over town about the centre and decided to come "just to be safe". The other is six months pregnant and was advised to come by her doctor.

Tebelopele is the name of a network of Voluntary Counselling and Testing Centres (VCT) in Botswana. The centres provide accessible and confidential voluntary counselling and testing services throughout the country. For many Batswana, the confidential nature of the centres are preferred to the government testing facilities. Clients at the centres are not required to reveal their names. Only a code number is given to each client for identification of the test.

As Ronald Molosiwa, Director of the centre in Gaborone puts it: "Botswana is still a very close-knit community and people are reluctant to go other health care facilities because their identities will be known".

Tebelopele is still a relatively new project, having started in 2000. But the response from the public has seen the centres expand to 8 in the country's major cities. The project is run by the Botswana government and the United States Centre for Disease Control and Prevention.

According to Molosiwa, introducing Tebelopele to the Botswana society has been an uphill battle. The stigma associated with HIV/AIDS has meant that people are afraid to find out about their status.

Cultural taboos regarding sexuality have also made it difficult for the Motswana on the street to come forward and want to be tested. For many, sex is seen as "something you do, not something you talk about". Molosiwa adds that Botswana society has been "ill prepared" to discuss HIV/AIDS and there is still a lot of shame and secrecy associated with the HIV/AIDS pandemic in the country.

In the past year, however, the centres have registered a steady increase of people coming to be tested. In April 2000, the Gaborone centre tested less than 100 people a month, but in October 2001, over 800 people had come through its doors. Molosiwa attributes this increase to the high visibility of the centres. Signs on bus stops and taxis and advertisements on the radio are turning Tebelopele into a talking point for people.

The average Tebelopele client in the urban centres is a young professional male or female. In rural areas, the clients are mostly middle-aged men. Over 80 percent of the clients at Tebelopele test negative for HIV. "This means that we have to try and reach those people that are not coming forward, there is still a lot of work to be done," Molosiwa told PlusNews.

Tebelopele is seen as an entry point for many HIV/AIDS programmes because of its community mobilisation initiatives. The outreach programmes distribute health education materials and condoms and also refer clients to services such as the government's TB preventative therapy and MTCT (mother-to-child transmission programme).

Counsellors at the centres provide intensive counselling sessions to equip HIV positive clients with skills on coping with HIV/AIDS. Female clients often ask counsellors to help them prepare to reveal their status to their partners and role-plays are conducted to deal with this.

"When the president got the ball rolling, Tebelopele decided to be a part of the national response to HIV/AIDS," Molosiwa explained. Tebelopele has contributed to HIV/AIDS prevention in Botswana by giving hope to those who test HIV negative.

Through counselling, the clients are empowered to develop "risk-reduction" plans to reduce their chances of getting infected in the future. While those who test positive are counselled about positive living with HIV. "But most of all, we are encouraging Batswana to be open and to talk about HIV/AIDS", Molosiwa added.

Theme (s): Care/Treatment - PlusNews,

[This report does not necessarily reflect the views of the United Nations]