Cultural beliefs and practices continue to shape how communities perceive, prevent and manage HIV/Aids, especially in rural areas with historical customs. Understanding these traditions can help improve health interventions and cultural sensitivity. This study explored the effects of AmaMpondo traditional practices and beliefs on the management of HIV/Aids in the Alfred Nzo district in South Africa’s Eastern Cape. The research aimed to understand how cultural norms such as initiation rites, ancestral rituals and gendered roles influence health-seeking behaviour, stigma and treatment adherence among community members.

The qualitative research design used semi-structured interviews with a purposive sample of 15 participants, including traditional healers, community leaders, healthcare professionals and residents. The study found that traditional leaders and healers play a pivotal role in shaping health discourse and promoting trust in HIV interventions when engaged ethically and respectfully. Integrating ancestral values and biomedical care was shown to enhance community participation and voluntary testing, and reduce stigma. The findings also revealed that gender dynamics and intergenerational dialogue significantly influence prevention practices, while peer education and digital health platforms help bridge informational and behavioural gaps.

Overall, the study demonstrated that culturally aligned and ethically grounded health interventions can foster inclusivity, strengthen health communication and improve adherence to HIV/Aids management strategies. These insights offer valuable implications for policymakers and healthcare practitioners seeking to enhance cultural competence and promote community ownership of public health initiatives in traditional African contexts.