Thetha Nami

We should let youth help youth navigate HIV

Africa Health Research Institute’s (AHRI) research has found that peer support is practical and popular with young people. In KwaZulu-Natal, the ‘Thetha nami’ (translation: ‘talk to me’) intervention saw peer navigators linking youth to HIV prevention and care. This matters because our youth are difficult to reach, but are most at risk for HIV, other STIs, and teen pregnancy.

Who can be a peer navigator?

Young men and women, aged 18 to 30 with matric, who are already active and respected in their communities are chosen for training. They learn to assess the sexual health needs and risks of their peers, and refer them for HIV prevention and care.

Peer navigators work 20 hours a week and are paid as community care-givers. They are popular with their young peers, and they provide decentralised, tailored care.

“Selecting and training area-based young people to promote health, assess peer needs, and tailor health and social referrals, works. We found it is feasible, acceptable and very popular with the local traditional and municipal leaderships,” said Dr Maryam Shahmanesh, a faculty member at AHRI.

The Thetha nami intervention trained 57 peer navigators in youth development, HIV and sexual health information, HIV counselling and testing, confidentiality, ethics, and research methods. This helped them to co-create HIV interventions for their communities. 90% of youth aged 16 to 29 accepted Thetha Nami peer navigator support.

Over six months in 2019:

  • 3000 female condoms were distributed
  • 41 450 male condoms were distributed
  • 6 871 youth engaged

Find out more about Thetha nami:

Shahmanesh, M., Okesola, N., Chimbindi, N. et al. Thetha Nami: participatory development of a peer-navigator intervention to deliver biosocial HIV prevention for adolescents and youth in rural South Africa. BMC Public Health 21, 1393 (2021).

Shahmanesh M, Mthiyane TN, Herbsst C, et al. Effect of peer-distributed HIV self-test kits on demand for biomedical HIV prevention in rural KwaZulu-Natal, South Africa: a three-armed cluster-randomised trial comparing social networks versus direct delivery. BMJ Global Health 2021;6:e004574.

Isisekelo Sempilo trial

AHRI’s Isisekelo Sempilo trial showed that testing for sexually transmitted infections and sexual and reproductive health improved uptake of HIV care and prevention among KZN youth.

Peer navigators were most effective when HIV testing, prevention and treatment were also promoted alongside STI testing and as part of good sexual health for fertility, sexual pleasure and healthy pregnancies.

They referred at-risk peers to youth friendly mobile clinics as part of the study, and many continued to visit clinics regularly.

Find out more about Isisikelo Sempilo:

Chidumwa, G., Chimbindi, N., Herbst, C. et al. Isisekelo Sempilo study protocol for the effectiveness of HIV prevention embedded in sexual health with or without peer navigator support (Thetha Nami) to reduce prevalence of transmissible HIV amongst adolescents and young adults in rural KwaZulu-Natal: a 2 × 2 factorial randomised controlled trial. BMC Public Health 22, 454 (2022).