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Education And Debate

How can HIV be prevented in South Africa? A social perspective

BMJ 2002; 324 doi: (Published 26 January 2002) Cite this as: BMJ 2002;324:229
  1. Catherine Campbell (, reader in social psychologya,
  2. Yodwa Mzaidume, outreach coordinatorb
  1. a London School of Economics, London WC2A 2AE,
  2. b Mothusimpilo Project, c/o Carletonville Hospital, Private Bag X2023, Carletonville, 2500, South Africa
  1. Correspondence to: C Campbell
  • Accepted 8 November 2001

South Africa's lack of government leadership in the fight against HIV and AIDS has resulted in disunity in local HIV/AIDS circles. Catherine Campbell and Yodwa Mzaidume suggest that peer education—with local people taking control of HIV prevention efforts—can be successful but depends on collaboration between many stakeholder groups at local, national, and international level

HIV and AIDS prevention programmes often have little impact because such programmes have traditionally had a biomedical focus and an emphasis on individual behaviour. Yet social and community level factors influence the rate and method of HIV transmission and can affect the success or failure of prevention programmes.

In this paper we discuss the importance of these factors with reference to a South African prevention programme. We argue that HIV prevention efforts are affected by the participation of a wide range of groups and processes at local, national, and international level. The scope of research, interventions, and policies must be widened to take this into account.

Summary points

The participation of local community members is a key element in HIV prevention worldwide

Despite the proliferation of community based approaches to HIV prevention, few studies have examined the role of social factors in a programme's success

In particular, little is known about why community participation affects sexual health

Community led peer education involves training local people to take control of HIV prevention efforts

This type of peer education in marginalised groups can create trusting and cooperative relationships in homogeneous local peer groups

The success of peer education also depends, however, on collaboration among diverse stakeholder groups at local, national, and international level

Community participation

Among marginalised groups in poor countries, providing information about health risks changes the behaviour of, at most, one in four people—generally those who are more affluent and better educated.1 This is because health related behaviours (such …

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