III. Methodology

This report is based on information collected during field visits to Lesotho in October, 2007 and February, 2008. Over the course of a total of four weeks in the field, Luyanda Ngonyama, the advocacy coordinator of the AIDS and Rights Alliance for Southern Africa (ARASA), and Diederik Lohman, a senior researcher for Human Rights Watch, conducted detailed interviews with key informants, including twenty-nine KYS counselors, five staff members of the KYS campaign office in Maseru, five KYS district managers, two KYS district logistics officers, twenty-six nurses, doctors and other health workers at a dozen clinics and hospitals, eighteen representatives of NGOs and support groups for people living with HIV and AIDS, as well as representatives of the World Health Organization (WHO), United Nations Development Program (UNDP), UNAIDS, and the embassy of the U.S.. We also interviewed eleven people who were tested through KYS. Before the interview, we told interviewees of the purpose of the interview, explained what issues would be covered, and asked if they wanted to proceed. We did not offer or provide any incentives.

We conducted the interviews in five cities and ten villages in five districts of Lesotho. We chose these towns and villages based on information suggesting that the KYS campaign had been active there; we did not conduct research in villages and towns where there was little or no KYS activity. We conducted semi-structured interviews in private where possible. The interviews covered a broad range of topics, including selection and training of counselors; outreach and testing work in communities; informed consent, confidentiality and pre and post-test counseling; supervision mechanisms, quality control, and independent oversight; and linkages to prevention, care and treatment. Most interviews were conducted at healthcare centers or at the homes of KYS clients and counselors. We identified interviewees through KYS staff, staff at healthcare centers and hospitals, support groups, and NGOs. The KYS counselors were mostly women, aged between 30 and 50. KYS clients were also mostly women, ranging in age from their twenties to eighties. The interviews were conducted either in English or in Sesotho with the help of an interpreter.

Locating KYS clients was a considerable challenge. We relied mostly on KYS counselors to help us identify and approach people who had tested through KYS. In such cases, the counselors would approach persons individually and explain that we would like to interview them about their experiences with KYS. If an individual agreed, the counselor would introduce him or her to us, we would explain our work, again assure the consent of the individual, and then conduct the interview in private. The small number of KYS clients and the selection of KYS clients by counselors likely resulted in a biased sample of individuals who had more positive experiences and represents a significant limitation of our investigation.

In this report, we withhold the names of most of our interlocutors. Many of the people we interviewed were HIV-positive and agreed to speak to us on condition that their identities remain confidential. Others did not want to be seen as publicly criticizing the KYS campaign. Many noted that the government was highly sensitive to any negative assessments of the KYS campaign and that some government officials had made it clear that criticism was not appreciated.

All documents cited in the report are either publicly available or on file with ARASA and Human Rights Watch.