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This case study illustrates that the use of appropriate mobile technology has a
positive impact on maintaining men’s participation in a health programme
focusing on HIV testing and education.
Recent research findings on the Imbizo Men’s Health Programme indicate that its
male participants responded positively to the use of SMS communications. SMS
was used to remind participants to go for HIV testing and inform them of
upcoming events promoting AIDS and gender awareness. Taken together, this use
of mobile technology has played an important part in ensuring that men have
remained involved in this public health initiative.
Imbizo is an HIV support and educational programme run by male counsellors for
men between ages of 16 to 55 years. It provides post-HIV testing counselling
and runs educational workshops on condom usage and HIV risk reduction, the
benefits of knowing one’s HIV status and good fatherhood. The programme is run
by HIVSA, a non-governmental organisation, and operates out of the ZAZI
voluntary counselling and testing (VCT) centre operated by the Perinatal HIV
Research Unit (PHRU) located at the Chris Hani Baragwanath Hospital in Soweto.
To date, the programme has reached over 10,000 men in the Soweto area since its
inception in 2005. Soweto, with South Africa’s largest urban population, has
some of the high levels of unemployment, poverty, and HIV prevalence in the
According to a recent academic study on Imbizo, the use of SMS messaging along
with other methods such as distributing branded clothing and educational
materials went far in keeping men interested and involved in the Imbizo
programme. The study was conducted by Abigail Dreyer, a public health
As Dreyer has indicated, “It would seem that understanding, flexibility,
adaptability and some level of creativity and motivation are required in order
to successfully interact with different ages of the male population in relation
to HIV related issues.”
One of the biggest problems facing HIV-awareness campaigns is how to engage
successfully with men as the group who unsuspectingly create vulnerability to
HIV among women and children. The education of men on HIV and AIDS is seen as a
key area to changing male attitudes and sexual behaviour to reduce the spread
of the AIDS pandemic.
Forty-four black South African men living in Soweto were interviewed for the
research. The men were mostly in 33 to 42 year old age range, unemployed, and
levels of education that ranged from basic to graduates from tertiary
institutions. Four were married, eight had partners and the remaining
thirty-two were single. They were all isiZulu first language speakers and
either spoke English as a second or third language. Many of the men were
long-term participants in the project and had been involved in the Imbizo
project for nearly two years.
Imbizo use SMS messaging to reach programme participants in two ways. Men who
test HIV negative, but who may be within a window period, are sent an SMS
reminder to retest at a later date. SMS is also used to notify men about events.
For example, in November 2009, Imbizo used SMS to contact men about a campaign
promoting the Sixteen Days of Activism Against Gender Violence as well as an
Imbizo Men’s Health Project will celebrate 16 Days to end violence from 25
November. We will send you more about the events soon.
A reminder that we will be having a debate on Friday 27 November at 10h00. T
shirts for all participating in debate. Imbizo Men’s Health.
According to Dreyer’s research, “The men felt that the use of SMS messages was
innovative and that it was a good strategy to keep them connected with the
Several responses from programme participants bear this out. Comments such as
“SMSes are personal because no one has my phone but me” and “SMSes are good
because I always have my phone with me” are indicative of appropriateness of
the technology for this mHealth programme.
In addition, the SMS communications were seen as trendy and adding to a
person’s self-esteem: “I think it is cool that they use SMSes, when my phone
goes beep beep and I say’ oh it is Imbizo, it’s like they are contacting me
because I am so important.”
More importantly, men appreciated the anonymity of the SMS messages which helps
in minimising any negative social stigma that may be attached to participating
in an AIDS programme. As one respondent indicated, “When my girlfriend reads
the message, it has no private details. I just say they got my number from a
The Imbizo project team uses BulkSMS’s Community SMS messaging service to send SMS
messages from their office computer to men who have registered to participate
in the Imbizo Men’s Health Programme. This BulkSMS.com application-to-person
(A2P) service provides Imbizo with a part-sponsored, discounted pricing that
helps in reducing the cost of public health related communication campaigns.
The Imbizo programme is one of a number of Health initiatives in South Africa
that have found SMS messaging crucial to their promotion of AIDS awareness and
voluntary HIV testing or the treatment and care for persons living with AIDS.