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HIV counselling and testing (HCT) is considered important because it is an entry point to a comprehensive continuum of care for HIV/AIDS. The South African Department of Health launched an HCT campaign in April 2010, and this reached 13,269,746 people by June 2011, of which 16% tested HIV positive and 400,000 of those were initiated into antiretroviral treatment. The overall objective of this project was to gain insight into the general perceptions about HIV testing in the different South African communities. Factors influencing testing in these communities were also explored. Discussions with twelve focus groups (FG) of 8-12 participants each were conducted with male and female participants recruited from both urban formal and informal communities in Cape Town and Durban. Participants included four racial groups represented by different age groups as follows: adolescents (12-17 years), youth (18-24 years) and adults (25 years and older). Data were analyzed using thematic coding. Among the key themes that emerged from the findings were the inaccurate perception of risk, fear of testing HIV positive, stigma and discrimination. Participants from both African and Indian FGs reported being less likely to do self-initiated HIV testing and counselling, while those from the FG consisting of young whites were more likely to learn about their HIV status through blood donations and campus HIV testing campaigns. Most FGs said they were likely to test if they understood the testing process better and also if the results are kept confidential. The present findings reiterate the importance of spreading positive messages and ensuring confidentiality for HIV testing in a society where there is still some stigma associated with people living with HIV/AIDS. This can partly be accomplished by the continuation of the national HCT campaign, which has been a considerable success in the fight against HIV/AIDS in South Africa during the past two years.

Policies are often developed without taking into account social science research findings and recommendations, despite the plethora of such research studies. This is largely because researchers and policy makers often work in isolation, yet if they worked synergistically they could have a significant impact on implementing interventions known to work to improve the lives of populations. Several approaches have been advanced to encourage policy makers to take heed of scientific findings and to urge scientists to take into account the needs of policy makers in designing their research agenda. This paper aims to illustrate how policy has been informed using the case study of the Orphans and Vulnerable Children project in South Africa. It further highlights the successes and challenges encountered thus far with this project. In some countries, particularly those of the north, there has been major progress in bridging this gap between research and policy; however, in developing countries much remains to be done.

The study assessed the proportion of HIV-infected educators that need antiretroviral treatment (ART) according to current criteria, and estimated the impact of ART on AIDS mortality by modelling scenarios with and without access to ART. Specimens for HIV testing were obtained from 17 088 educators and a sub-sample of 444 venous blood specimens from HIV-positive educators was selected for a CD4 cell count analysis. The Spectrum model package was used for estimating AIDS-associated mortality and projecting the impact of ART scenarios. The results of the CD4 cell count analysis in the HIV-positive educator study population showed that 8% had fewer than 100, 22% fewer than 200, 52% fewer than 350, and 72% fewer than 500 CD4 cells/mm3. Based on the proportion of HIV-positive educators with a CD4 cell count < 200 cells/mm3 we estimated that in 2005 approximately 10 700 educators would need ART according to current SA government guidelines. For the baseline scenario without ART the number of AIDS deaths among HIV-infected educators was projected to increase from 1 992 deaths in 2000 to 5 260 in 2010. The number of projected AIDS deaths in the educator study population was estimated to be 4 414 in 2005, with almost 50% of the AIDS deaths occurring in the 35 - 44 age group. The estimates suggest that in 2005 9.1% of the HIV-infected educators, or 1.2% of the total educator population, will be dying of AIDS. By 2010, a reduction of almost 50% in AIDS deaths was estimated for the treatment scenario with 90% ART coverage, compared with the baseline scenario without treatment. The ART impact scenarios illustrate that a relatively high ART coverage would be needed to ensure a substantial impact of ART on HIV/AIDS-associated mortality.