South Africa has the largest antiretroviral (ARV) therapy program in the world, but given that it also has the world’s largest HIV epidemic, overall access to treatment is low. Continued stigma around the disease also means that many patients are not diagnosed until they have passed the threshold for treatment to be effective. Most problematically, even those who are prescribed treatment in time often do not receive enough information and/or support to effectively follow the precise and unforgiving medication protocol, resulting in widespread drug resistance. Lay counselors have been hired in some clinics to attempt to address this issue, but for a variety of reasons, their addition has not had the desired effect on patient medication adherence.
Masivukeni, meaning "Let's Wake Up" in Xhosa, is a computer-based intervention used by non-professional peer counselors in South Africa to help HIV-positive adults improve adherence to treatment by enlisting the support of a “treatment buddy” (e.g., a partner, friend, or family member), so that together they can understand the importance of taking their medication and maintaining high levels of overall treatment adherence. The addition of technology to the program is intended to support counselors with limited training and supervision while ensuring greater standardization in implementation. In providing a detailed protocol for counselors to follow when helping non-adherent patients, Masivukeni also provides patients with interactive activities and videos that help explain the importance of adherence, how HIV and HIV-treatment regiments affect the body, and how treatment resistance can develop.