Health literacy and HIV : A qualitative content analysis of South African ProvincialImplementation Plans

Abstract South Africa has in many ways been successful in combating the spread of HIV. Testing campaigns, the expansion of treatment to all children under one year and the regular launch of national implementation plans are said to be some of the measures that have contributed to this development. At the same time, the number of HIV infections are still high and many people lack access to treatment. This has created a need for evaluating what can be done in order to take the next step in the fight against HIV. Therefore, the South African strategy to combat HIV is investigated from a health literacy-perspective. Health literacy is a concept that, apart from focusing on literacy, also acknowledge the importance of factors such as how information is communicated, socio-economic conditions, behavioural norms, cognitive ability and the importance of cultural understandings when people try to make sense of health-related concepts and interact with health care professionals. A qualitative content analysis is performed on the Implementation Plans for combating HIV of three South African provinces: KwaZulu-Natal, North West and Gauteng, with the aim of identify if, and if so how, the content of the plans can be linked to health literacy and what insights that might generate. Whether health literacy is approached as an asset or as a risk has proved to be extra interesting during the analysis. The content of the implementation plans can in many ways be linked to health literacy, something that can potentially be positive for the fight against HIV. The plans do, however, lack an element of providing citizens with the opportunity to develop skills to more critically analyse information and to use health-related knowledge in new situations. Simply focusing on basic health education is not necessarily a problem. However, it puts great demands on the capacity of healthcare professionals to communicate crucial information about treatment in a way that is accessible to every patient. That, especially in terms of word choice and language, could have been more clearly emphasized. The importance of stigma, as well as of behavioural norms, are also emphasized and is something that could benefit from strengthening the general level of critical thinking as well