LGBTIQ Health

Sexuality has wended a historical path as a subject of social research in general and as a unit of analysis in migration studies in specific. Whereas gender has been stereotypically brought forward as females, until recent years sexuality has been linked to the scope of heterosexual reproduction and family life. However, there is a large gap in migration literature regarding LGBT refugees. To fill this gap, the present study was an attempt with the help of the Norbert Elias' established and outsider figuration theoretical frameworks analyses the formation of identity in post migration stage of queer migrants coming from the country of Iran where the issue of sexual orientation sits always into heteronormative gender identities. In the current research, twelve individuals participated. They were living all in the Nordrhein-Westfalen state of Germany during the last five years and had applied for asylum upon their arrival on the ground that returning to their country would lead to persecution on account of sexual orientation. The participants answered questions of semi-structured and flexible interviews. For the data analysis, I employed open coding as well as thematic analysis techniques. The results showed that sexual identity interacts with the other aspects of the participants' identities and with their positioning process. That is to say, intersection of various identities in various social relational contexts ends to constant tensions of exclusion and belonging.

Resumo A partir da análise de entrevistas feitas com profissionais de saúde que atuam na atenção básica na cidade de São Paulo, este artigo busca identificar: 1) como descrevem pessoas LGBTI+ e suas demandas de saúde; 2) como avaliam sua formação para lidar com esse segmento; 3) quais os principais obstáculos para atendê-lo; e 4) como descrevem o atendimento provido. Por meio de uma análise foucaultiana do discurso e fontes da sociologia da medicina, reconheceu-se a preponderância do olhar anatomopatológico no reconhecimento do segmento LGBTI+, a avaliação negativa da formação para lidar com essa população, assim como a persistência de obstáculos ao atendimento dessas pessoas, que ainda é avaliado como deficiente. Conclui-se que a hegemonia do modelo biomédico e do imperativo do aprendizado prático criam obstáculos ao provimento de atendimento integral à população LGBTI+.

Resumo O crescente envelhecimento populacional e as transformações socioculturais do nosso tempo conduzem a novas necessidades, não somente de cuidado, mas também para atender a uma nova perspectiva do conceito de saúde, no qual cuidar da doença se tornou ação limitada. Este estudo trata-se de um ensaio baseado na literatura científica e se propõe a pensar sobre uma pequena parte desta grande questão: o apoio social como parte da atenção integral à saúde do idoso. Para isso, realizou-se uma revisão narrativa da literatura nas bases de dados Pub Med/MedLine, Crochane e Scopus, bem como nas listas de referências dos artigos encontrados. Parte-se da compreensão do papel do apoio social e das redes microssociais na saúde do idoso. A seguir, discutimos formas de avaliar o apoio e a rede social e refletimos sobre o papel do apoio social no Sistema Único de Saúde. Por fim, aborda-se o manejo do apoio social. Como considerações finais, são destacados os principais desafios para que o Apoio ...

Based on research on same-sex sexuality, religion and transnational migration in Belgium, this article looks at how the process of transnational migration intersects with the fashioning of the moral selves of queer Muslim migrants. Bringing together the concept of lived religion with an anthropological notion of moral selves, I argue for the importance of taking into account complexity and ambivalence in the understanding of moral subjectivities.

Adolescent with disabilities in Zambia face numerous challenges in accessing sexual and reproductive health. Cultural belief still regards them as not sexually active. The government has also failed to promote policies that facilitate access to sexual and reproductive services by adolescent with disabilities.

Background: Young people in KwaZulu-Natal and Mpumalanga South Africa are at high risk of HIV and other sexually transmitted infections. Therefore, awareness programs are needed to reach these young people and change their knowledge, attitudes, and behaviors. Objective: The objective of this study is to use cross-sectional data from grade 10 female and male learners in randomly assigned intervention and control schools to examine their knowledge, attitudes, and sexual behaviors. Methods: Participants, who were in grade 10 in the 2018 school year and attending schools, were randomly assigned to the intervention and control arms for implementation of the Department of Basic Education’s adapted life orientation curriculum that included scripted lesson plans. The study took place in two high HIV prevalence provinces in South Africa. Participants completed self-administered tablet-based surveys and female participants provided a dried blood spot for HIV testing. Results: Results demonstr...

We send a heartfelt thanks to all the victim/survivors, practitioners & researchers who have taken the time and interest to tell their stories, listen to our queries, and support our fledgling efforts to explore this field. There are too many people to name, but you know who you are….without your support over the last few years, we never would have gotten this far in our journey to both understand better the dynamics of this heart wrenching issue as well as begin to find more effective and efficient ways to support the healing process….

Resumo O objetivo deste estudo é identificar e analisar os indicadores de qualidade de vida e apoio/suporte social, bem como os descritores do perfil utilizados por homens de meia-idade que buscam e/ou se interessam por relações com o mesmo sexo em plataformas digitais. O desenho metodológico é de natureza quantitativa, descritiva de corte transversal. A coleta de dados foi realizada por meio de um questionário sociodemográfico, o WHOQOL-bref e a Escala de Apoio Social do Medical Outcomes Study (MOS). Os dados foram analisados com auxílio do Statistical Package for the Social Sciences® (SPSS). Os resultados confirmaram que os descritores mais prevalentes foram aqueles que buscaram se desvencilhar de noções que pudessem remeter ao universo da maturidade e velhice fragilizadas, além do reforço às representações hegemônicas de masculinidade. Em relação aos escores totais de apoio social e qualidade de vida, estes apresentaram correlação diretamente proporcional, significativa e de magn...

Negative attitudes towards Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) communities exist in South Africa, regardless of the constitutional provision and anti-discriminatory policies. Cases of violence against LGBTI persons due to their sexual orientation have been reported in the media and scientific journals. This study focused on LGBTI students of a rural-based university. It explored and described their experiences in interacting with members and structures of the university community.  A qualitative descriptive, exploratory, and contextual design was used and data were collected through individual face to face in-depth interviews. Interviews were conducted with 20 participants, who were selected through snow-balling technique. Thematic content analysis was used to analyse data.Stigma and discrimination were the mains theme that emerged from the analysis of the interviews. Four sub-themes and various categories were derived from the main theme. Despite the constituti...

Communication about sexual and reproductive health and rights (SRHR) is important and central to health (Sen & Govender, 2015). Whilst children listen to their peers, the peer norm-behaviour is moderated by parental communication. Research suggests that a lack of communication between parents and their children may cause adolescents to turn to peers and that peers may influence their behaviour (Whitaker & Miller, 2000). Whilst research is unclear on the temporal sequence of the relationships between parent-child communication and preventative sexual behaviours, there seems to be some benefits in parent-child communication as it is reported to be associated with contraceptive and condom use in other African countries (Biddlecom, Awusabo-Asare, & Bankole, 2009; Hutchinson, Jemmott, Jemmott, Braverman, & Fong, 2003). Studies on communication between parents and their children about sexuality reflect the diversity of this topic. Research in this field investigates parent-child communication, parent-adolescent communication, parentpreteen and mother-daughter communication (Bastien,

Holding leaders accountableAbout AIDS Accountability International AAI is an independent non-profit organization established to increase accountability and inspire bolder leadership in the response to the AIDS epidemic. It does so by rating and comparing the degree to which state and non-state actors are fulfilling the commitments they have made to respond to the epidemic. AAI aims to build bridges between actors and institutions that collect and analyze primary data in the field of HIV/AIDS and those who make use of this data in different contexts, such as policy makers and advocates. AAI provides these actors with a compass that points to new policy and programmatic directions and helps stimulate debate on the need for greater accountability and leadership. AAI’s efforts are made possible through the support of

La santé sexuelle fait partie intégrante des critères essentiels à la santé globale. Chaque individu-e-x le souhaitant devrait avoir la possibilité d'expérimenter une vie sexuelle agréable, sécuritaire, sans coercition, discrimination ni violence. Ces droits sexuels signifient non seulement pouvoir se protéger contre les infections sexuellement transmissibles et les grossesses non désirées le cas échéant, mais aussi se sentir bien dans sa sexualité. Or, l'adolescence est marquée par l'exploration de la sexualité. Cet article vise à donner aux professionnel-le-x-s de la santé des outils et des pistes de réflexion afin de réaliser auprès des patient-e-x-s adolescent-e-x-s une anamnèse de la santé sexuelle inclusive, notamment par rapport aux questions de diversité sexuelle et de genre, pour améliorer l'accès optimal aux informations et aux soins en matière de santé sexuelle.

Taking an inclusive sexual health history of adolescents Sexual health is an integral part of overall health. Every individual who wishes to do so should have the opportunity to experience safe, enjoyable sex, free of coercion, discrimination and violence. These sexual rights mean not only being able to protect oneself from STIs and unwanted pregnancies when appropriate, but also feeling good about one's sexuality. Adolescence is a time of discovery and exploration of sexuality. The purpose of this article is to provide health professionals with strategies for reflection and action in order to conduct an inclusive sexual health history with adolescent patients, particularly with respect to sexual and gender diversity issues, so that everyone has optimal access to sexual health information and care.

Thanasis Theofilopoulos (Symplexis) and Victoria Topalidi (Universal Training) conducted a research in order to identify the multiple challenges and inequalities LGBTQI+ people have faced in Greece during the Covid-19 pandemic as well as to assess the training needs of professionals/support services providers working in the field and collect best practices and initiatives implemented in the country.
The research was conducted in the framework of the Erasmus+ “RAINBO – Raising the Digital Literacy of Professionals to Address Inequalities and Exclusion of LGBTQI+ Community” project whose main aim is to build the capacity of support services providers in order to be able to provide their services remotely during a time of crisis (like the Covid-19 pandemic) while responding efficiently to the needs of LGBTQI+ people.

The effectiveness of education programmes, including comprehensive sexuality education (CSE), to address gender-based violence in schools is under increasing scrutiny. Explanations for the persisting challenges with these programmes have so far typically pointed towards 'culture'. Drawing on a qualitative case study in Ethiopia, this paper analyses the relations between gender-based violence and culture, as it is presented in CSE. It reveals that uncritical conceptions of tradition and modernity, as well as 'good' and 'bad' cultures in CSE, fail to address and discuss gender relations and patriarchy as the root causes of gender-based violence. This enhances the vulnerability of young women and the reduces the effectiveness of CSE in addressing gender-based violence. 1. Introduction Tensions that arise with promoting educational initiatives and conducting research on sexuality in developing contexts are being increasingly reported. On the one hand development and modernisation are celebrated by young people as inspiring an ideal of free and liberal sexual practices; yet at the same time they are viewed to be at odds with a traditional cultural identity (Leclerc-Madlala, 2004; Parkes et al., 2016; Lalor, 2004; Spronk, 2009). For instance, Lalor (2004) argues that in Sub-Saharan Africa, there is a widespread (though contested) belief that modernisation has led to a dramatic increase in child sexual abuse; and Leclerc-Madlala (2004) reveals how ideals of modernity and cosmopolitanism are believed to lead to transactional sex in South Africa. Spronk (2009) also describes that sexuality is centrally placed in the positioning of young urban professionals in Nairobi, as modern subjects. However, for these young professionals, 'proper morality' remains important to their modern sexual identities and is strongly connected to cultural heritage and notions of 'Africanness'. It is without doubt that development efforts, including educational programmes for the promotion of sexual health, affect notions of culture, modernity, and tradition, as well as what is considered to be 'proper' (see e.g.

This summary research report briefly presents the main findings of my desk and field (personal interviews with relevant stakeholders, experts etc. including representatives of Greek LGBTQI+ organizations) survey conducted in Greece for the purposes of the Project "PARADISO" (funded by the General Secretariat for Research and Innovation, K/E 81012) during February and March 2022 regarding LGBTQI+ people and health sector in Greece before and during the Covid-19 pandemic.

There were all my answers, I had been honest. I used to do drugs, so we talked about that and how guys treated me and things like that. So, yes, we started talking more after that piece of paper. I wouldn't have opened up otherwise, sure if she would have asked, but I still wouldn't have told as much without that paper. So, we had a conversation, it went well." Lisa, 17 years, interviewed for Study III Contents

Negative attitudes towards Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) communities exist in South Africa, regardless of the constitutional provision and anti-discriminatory policies. Cases of violence against LGBTI persons due to their sexual orientation have been reported in the media and scientific journals. This study focused on LGBTI students of a rural-based university. It explored and described their experiences in interacting with members and structures of the university community.  A qualitative descriptive, exploratory, and contextual design was used and data were collected through individual face to face in-depth interviews. Interviews were conducted with 20 participants, who were selected through snow-balling technique. Thematic content analysis was used to analyse data.Stigma and discrimination were the mains theme that emerged from the analysis of the interviews. Four sub-themes and various categories were derived from the main theme. Despite the constituti...

Background. The level of unintended pregnancies among teenage girls in South Africa (SA) has remained a public health concern. However, studies and interventions generally do not consider young men's involvement in teenage pregnancies. Objective. To investigate the sociodemographic and sexual behaviour characteristics of young men who have impregnated at least one teenage girl. Methods. The study used data from the Centre for Justice and Crime Prevention ( ), which included responses from young men (aged 12 -22 years) across all SA provinces. Univariate and bivariate analyses and binary logistic regression were performed. Results. The results showed that 93.2% of the sample had ≥2 lifetime sexual partners, 22.4% rarely used condoms and 11.5% had never used condoms. Teenage pregnancy incidence was ≥35% in all provinces except Gauteng and the Western Cape. The likelihood of being involved in a teenage pregnancy was higher among respondents who reported having ≥2 lifetime sexual partners (odds ratio (OR) 2.510; 95% confidence interval (CI) 0.43 -14.77). Respondents with a higher education were less likely to be involved in a teenage pregnancy (OR 0.819; 95% CI 0.36 -1.84) than those with a lower education (OR 1.219; 95% CI 0.59 -2.50). Engaging in multiple sexual partnerships could increase the vulnerability of young people to sexually transmitted infections or teenage pregnancies. Initiatives to create awareness among SA youth regarding the consequences of sexual behaviour are recommended, with a specific focus on addressing young men's involvement in teenage pregnancy.

Background Acces to sexual and reproductive health and rights information during adolescence is a basic human right. This study investigated the key informants’ perspectives on the benefits, sources of information, and the determinants (enablers and hindrances) of sexual and reproductive health and rights information among early adolescents in Rwanda. Methods a qualitative study using semi-structured interviews with purposively selected public and private key informants in Rwanda was conducted. Interview transcripts were imported in Nvivo 11 for thematic analysis. Results In total, sixteen interviews involving an equal number of male and female participants were conducted. Despite it being perceived as a taboo topic, participants acknowledged sexuality education as beneficial for early adolescents and confirmed that there are various channels for accessing gender and sexuality information. The school comprehensive sexuality education was depicted as a common source of information, w...

This paper sought to examine the role and effectiveness of an extra-curricular school based programme, Soul Buddyz Clubs (SBC) on HIV knowledge, attitudes, behaviours and biomedical outcomes. Secondary data analysis was performed on survey data of a nationally representative sample that was restricted to 10 -14-year-old males and females, using bivariate and multivariate methods in Stata14. Fifteen focus group discussions and 24 in-depth interviews conducted with SBC members, programme implementers and stakeholders in five provinces were analysed using thematic analysis in ATLAS.ti. The results indicated that 12% of respondents were exposed to SBC. Children exposed to SBC were more likely to be medically circumcised (AOR 2.38; 95%CI 1.29 -4.40, p=0.006), had correct HIV knowledge (AOR 2.21; 95%CI 1.36 – 3.57, p<0.001) and had less stigmatising attitudes (AOR 0.54; 95%CI 0.31-0.93, p=0.025) – in comparison to those not exposed. Qualitative findings also supported some of the quant...

Key populations have always been disproportionately affected by the global HIV epidemic, and their relative risk continues to increase. In 2019, key populations (namely, men who have sex with men (MSM), sex workers of all genders, transgender individuals, prisoners and people who inject drugs) and their sexual partners accounted for 62% of new infections worldwide [1]. Their ability to keep themselves and others healthy and safe from HIV is compromised by multiple intersecting forms of inequality and stigma and discrimination, creating barriers at the individual, interpersonal, community and societal levels [1]. Young people who are members of one or more of these key populations face further challenges due to their life inexperience, lack of awareness or understanding of HIV risk factors and other age-related factors, such as conservative family and community attitudes that deny young peoples’ ability to make decisions for themselves and unfettered access to HIV services. Finding n...

The role and importance of self-care in the continuum of health care are becoming important subjects of debate among social scientists and health professionals. Interest in the self-care component of health services is stimulated by the convergence of diverse pressures common to health services systems. Depersonalized medical care, rising costs of high technology, focus on curative care, growth of lay knowledge, recognition of the limits of medical care, and documentation of the impact of the individual’s health behavior on patterns of morbidity are all factors stimulating new thinking regarding the importance of individuals and families to the effective and efficient functioning of health service systems.

Background: This report presents the findings of a quantitative situational analysis of the use and perceptions of the quality of health care services among healthcare users in two districts, using survey methodology. The report was commissioned by the AIDS Foundation of South Africa (AFSA) as part of their three-year Sexual and Reproductive Health and Rights (SRHR) programme. The study is framed within a Sexual and Reproductive Justice framework. This conceptual approach expands the rightsbased perspective to consider wider contextual factors like socioeconomic status, gender, disability, race, and sexuality as potential barriers to Sexual and Reproductive Health and Rights (SRHR). Aim: The primary aim of the study was to identify the key advocacy strategies and levers for change with respect to access to SRHR, identified from a situational analysis of selected facilities. These will inform the work of AFSA's implementing partners. Method: Survey methodology was used to ascertain people's own perceptions and experiences of services in terms of access, quality, and satisfaction with general as well as SRH-specific services in the public health system. A Healthcare User questionnaire was administered with people exiting three public health facilities in OR Tambo district in the Eastern Cape and three in Gert Sibande district in Mpumalanga. Both districts are part of the South African NHI (National Health Insurance) pilot. The data from the six facilities were analysed using SPSS and disaggregated according to gender, sexuality, and geographic location, where possible. Summary of main findings: i. Supporting previous research, the findings indicate that healthcare users in the selected districts are predominantly "black Africans, poor, uninsured, and rural" (Harris et al., 2011, p. S102). When considering SRH-specific services specifically:  A large proportion of respondents reported that their social characteristics (gender, sexual identity/orientation, or age) influenced the SRH-specific services they received. i. For sexual and gender minorities, and for very young (teenage) and older (<40 years) participants, age was also regarded as influencing the quality of care received, similar to findings reported for accessing general healthcare. ii. Young respondents were particularly concerned about privacy and confidentiality in receiving SRH-specific services. iii. Sexual and gender minorities reported more frequent perceptions of health workers being unable or unwilling to assist them, than their heterosexual counterparts.  Across participant characteristics, when reporting on future access to SRH-specific services, respondents highlighted the importance of proximity of services in their likelihood of accessing SRH services.

Background: This report presents the findings of a quantitative situational analysis of the use and perceptions of the quality of health care services among healthcare users in two districts, using survey methodology. The report was commissioned by the AIDS Foundation of South Africa (AFSA) as part of their three-year Sexual and Reproductive Health and Rights (SRHR) programme. The study is framed within a Sexual and Reproductive Justice framework. This conceptual approach expands the rightsbased perspective to consider wider contextual factors like socioeconomic status, gender, disability, race, and sexuality as potential barriers to Sexual and Reproductive Health and Rights (SRHR). Aim: The primary aim of the study was to identify the key advocacy strategies and levers for change with respect to access to SRHR, identified from a situational analysis of selected facilities. These will inform the work of AFSA's implementing partners. Method: Survey methodology was used to ascertain people's own perceptions and experiences of services in terms of access, quality, and satisfaction with general as well as SRH-specific services in the public health system. A Healthcare User questionnaire was administered with people exiting three public health facilities in OR Tambo district in the Eastern Cape and three in Gert Sibande district in Mpumalanga. Both districts are part of the South African NHI (National Health Insurance) pilot. The data from the six facilities were analysed using SPSS and disaggregated according to gender, sexuality, and geographic location, where possible. Summary of main findings: i. Supporting previous research, the findings indicate that healthcare users in the selected districts are predominantly "black Africans, poor, uninsured, and rural" (Harris et al., 2011, p. S102). When considering SRH-specific services specifically:  A large proportion of respondents reported that their social characteristics (gender, sexual identity/orientation, or age) influenced the SRH-specific services they received. i. For sexual and gender minorities, and for very young (teenage) and older (<40 years) participants, age was also regarded as influencing the quality of care received, similar to findings reported for accessing general healthcare. ii. Young respondents were particularly concerned about privacy and confidentiality in receiving SRH-specific services. iii. Sexual and gender minorities reported more frequent perceptions of health workers being unable or unwilling to assist them, than their heterosexual counterparts.  Across participant characteristics, when reporting on future access to SRH-specific services, respondents highlighted the importance of proximity of services in their likelihood of accessing SRH services.

Background Sexual and reproductive health and rights are critical entitlements best supported through human rights-based approaches empowering rights-holders to claim their rights and duty bearers to fulfil their obligations. Implementing these requires information on the current needs and challenges faced by those seeking to claim their sexual and reproductive health and rights. We aimed to identify the underlying factors influencing the realisation of sexual and reproductive health and rights for adolescent girls and young women living Ugandan slums by: (1) exploring the role of relevant service providers and stakeholders; and (2) uncovering knowledge and gaps in protecting adolescent girls’ and young women’s sexual and reproductive health and rights. Methods Qualitative data were collected through focus groups and interviews focused on current knowledge, behaviours and attitudes towards sexual and reproductive health and rights among adolescent girls and young women, service prov...

Adolescents&#39; sexual and reproductive healthcare (SRH) needs have been prioritized globally, and they have the rights to access and utilize SRH services for their needs. However, adolescents under-utilize SRH services, especially in sub-Saharan Africa. Many factors play a role in the under-utilization of SRH services by adolescents, such as the attitude and behaviour of healthcare workers. The aim of this study therefore, was to explore and gain an in-depth understanding of healthcare workers&#39; beliefs, motivations and behaviours affecting adequate provision of these services to adolescents in South Africa. Twenty-four healthcare workers in public SRH services in Cape Town, South Africa participated in this qualitative study through focus group discussions. To fulfill the aims of this study, nine focus group discussions were conducted among the SRH nurses. SRH nurses indicated that they are experiencing challenges with the concept and practice of termination of pregnancy. They...

This study used a combination of qualitative and quantitative methods. Qualitative methods compared attitudes between healthcare workers who received the training intervention and those who did not. Quantitative methods were used to compare similar changes in awareness amongst healthcare workers before and after receiving the training. We explored shifts in attitudes towards key populations, changes in awareness of health issues related to stigma, discrimination, and changes in capacity to manage sexual health and HIV risk behaviours, including substance use and anal sex. Results: The findings indicate that the training intervention resulted in a shift in attitudes, increased empathy for key populations, a reduction in negative and discriminatory moral-based judgements towards key populations and their behaviours, and increased self-perceived capacity to provide appropriate health services to key populations. Over 70% of healthcare workers trained in this programme strongly agreed that this intervention helped to increase awareness of psychosocial vulnerabilities of key populations, and address stigmatising attitudes. Conclusion: The findings suggest that sensitisation training increases healthcare workers' knowledge and awareness about specific HIV-related health needs and psychosocial vulnerabilities of key populations, reduces moralising and judgemental attitudes, and results in healthcare workers feeling more skilled to provide appropriate and sensitive services.

Background: Sensitisation training can reduce judgemental and discriminatory attitudes amongst healthcare workers. The ‘Integrated Key Populations Sensitivity Training Programme for Healthcare Workers in South Africa’ aimed to improve access to appropriate and nonjudgemental health services for ‘key populations’, specifically men who have sex with men, sex workers and people who use drugs, through the sensitisation of healthcare workers. Objectives: The aim of this study was to evaluate the effects of the integrated key population sensitisation training intervention for healthcare workers, conducted between 2013 and 2014 in South Africa. Methods: This study used a combination of qualitative and quantitative methods. Qualitative methods compared attitudes between healthcare workers who received the training intervention and those who did not. Quantitative methods were used to compare similar changes in awareness amongst healthcare workers before and after receiving the training. We e...

Men who have sex with men (MSM), sex workers (SW) and people who use drugs (PWUD) are at increased risk for HIV because of multiple socio-structural barriers and do not have adequate access to appropriate HIV prevention, diagnosis and treatment services. To examine the context of access to healthcare experienced by these three &#39;Key Populations&#39;, we conducted a qualitative study in two South African cities: Bloemfontein in the Free State province and Mafikeng in the North West province. We carried out in-depth interviews to explore healthcare workers&#39; perceptions, beliefs and attitudes towards Key Populations. Focus group discussions were also conducted with members of Key Populations exploring their experiences of accessing healthcare. Healthcare workers described their own attitudes towards Key Populations and demonstrated a lack of relevant knowledge, skills and training to manage the particular health needs and vulnerabilities facing Key Populations. Female SW, MSM an...

Background: Men who have sex with men (MSM), sex workers (SW) and people who use drugs (PWUD) are at increased risk for HIV because of multiple socio-structural barriers and do not have adequate access to appropriate HIV prevention, diagnosis and treatment services. Objective: To examine the context of access to healthcare experienced by these three ‘Key Populations’, we conducted a qualitative study in two South African cities: Bloemfontein in the Free State province and Mafikeng in the North West province. Method: We carried out in-depth interviews to explore healthcare workers’ perceptions, beliefs and attitudes towards Key Populations. Focus group discussions were also conducted with members of Key Populations exploring their experiences of accessing healthcare. Results: Healthcare workers described their own attitudes towards Key Populations and demonstrated a lack of relevant knowledge, skills and training to manage the particular health needs and vulnerabilities facing Key Po...

Although there are several studies internationally on gender and sexual orientation diversity, these are limited in the Southern African Development Community (SADC). This special issue contains articles written from different Institutions of Higher Education (IHE) in the SADC region on experiences of LGBTI individuals covering sexual health, teaching and training, advocacy and interventions. The aim of publishing this research is to disseminate information for broader advocacy to destabilise hetero-and cis-normativity. The study sites included rural and metropolitan-based institutions and diverse research designs were used. Most of the research findings presented here indicate that the institutions of higher education in SADC are still heteronormative and LGBTI staff and students are marginalized, prejudiced and discriminated Nduna, Mthombeni, Mavhandu-Mudzusi and Mogotsi LGBTI experiences in institutions of higher education 2 against. Some studies report that there are activities in a few institutions harnessed in order to create conducive teaching and learning environments for and about sexual orientation and gender identity in the SADC.

The female condom (FC) was introduced in South Africa in 1998 marking a parallel anniversary to this 20th edition of the South African Health Review. The FC programme has grown rapidly from a pilot phase to a national programme that is one of the largest government-funded FC programmes worldwide. Twentyseven million FCs were distributed in South Africa in 2015/2016 exceeding the country’s National Strategic Plan (NSP) target of 25 million annually by 2016. The primary objective of this evaluation conducted in 2014–2016 was to evaluate the national FC programme and identify determinants of FC uptake and continued use among couples. The study aimed to provide an evidence base for the future direction of South Africa’s FC programme and to identify health system provider and client barriers and facilitators to FC uptake and continued use. The evaluation included four components: a national survey in the public and private sectors consisting of interviews with providers and clients and a...

TASA is the professional association of Sociologists in Australia. Each year TASA hosts its annual conference in different locations across capital cities and regional towns. The aim of each Conference is to further progress the Sociological agenda to local communities and students who might not have the funds to travel. TASA is ably assisted with Canberrabased Conference Solutions and TASA Conferences have the feel of 'community', which is great for learning and networking. The Conference proceedings has been compiled and formatted by TASA member Roger Wilkinson. It is hoped that the proceedings gain wide coverage amongst the sociological community and concerned individuals who might be searching the Internet for contemporary research about local, Australian and overseas research.

Significant human experiences seem to include the need to explore, talk about, and continually shape what gives us meaning in life through those experiences. This can be done in religious ways, formalized with worship, rituals and scripture that honour our personal experiences. But it is also done in less formalized ways, in stories we tell about the joy and pain of living and dying. A careful review of best, promising and emerging practices involving spiritual approaches for torture survivors demonstrates a variety of support benefits and the need for further research. While the literature does not reflect approaches that meet the criteria for best practices, there are important promising and emerging approaches that merit attention. A consistent theme in the literature is the limitations of clinical language. Spiritual approaches are rarely described by average people as “techniques” to address psychological issues. The healing value of telling a trauma story remains challenging t...

Background: The uptake of findings from sexual and reproductive health and rights research into policy-making remains a complex and non-linear process. Different models of research utilisation and guidelines to maximise this in policy-making exist, however, challenges still remain for researchers to improve uptake of their research findings and for policy-makers to use research evidence in their work. Methods: A participatory workshop with researchers was organised in November 2017 by the Academic Network for Sexual and Reproductive Health and Rights Policy (ANSER) to address this gap. ANSER is a consortium of experienced researchers, some of whom have policy-making experience, working on sexual and reproductive health and rights issues across 16 countries and 5 continents. The experiential learning cycle was used to guide the workshop discussions based on case studies and to encourage participants to focus on key lessons learned. Workshop findings were thematically analysed using specific stages from Hanney et al.'s (Health Res Policy Syst 1:2, 2003) framework on the place of policy-making in the stages of assessment of research utilisation and outcomes. Results: The workshop identified key strategies for translating research into policy, including joint agenda-setting between researchers and policy-makers, as well as building trust and partnerships with different stakeholders. These were linked to stages within Hanney et al.'s framework as opportunities for engaging with policy-makers to ensure uptake of research findings. Conclusion: The engagement of stakeholders during the research development and implementation phases, especially at strategic moments, has a positive impact on uptake of research findings. The strategies and stages described in this paper can be applied to improve utilisation of research findings into policy development and implementation globally.

This thesis examines HIV social research investigating Asian men who have sex with men (MSM) and their HIV health needs in Australia. In recent years, there has been growing awareness in HIV discourse, based on a ‘diversity’ promotion in the gay and lesbian community, of the exclusion/rejection of Asian MSM from the gay community and from gay-community-led HIV services and social research. I argue that this is part of a racism and misogynist culture crucial to the formative structures of gay, male identity. This aspect of gay male culture is avoided when focusing on Asian or NESB HIV issues in research because of the higher representation of gay, white, male interests in HIV social research. There are further barriers to viewing Asian MSM’s rejection/reactions ‘anglocentricism’ in the gay male community – as symptomatic of an epistemological racism in Australian research. Since the climate of discourse in Australia does not support analysis of racism in research or policy-making, ‘g...

View related articles View Crossmark data Citing articles: 3 View citing articles 'Intersectionality, kyriarchy and refraction': Theorising MCMF LGBTIQ in Diaspora As Dalacoura writes, 'Homosexuality has […] become a source of intense cultural contestations at a global level' (2014: 1290). In parts of Africa, Asia and the Middle East,

Goals of the review The USAID Sexual HIV Prevention Programme (SHIPP) was designed in order to assist the South African Government (SAG) in implementing effective HIV combination-prevention programmes. The goal of this document is to provide a synthesis of what is known about the drivers of HIV infection and an understanding of HIV prevention needs, opportunities, challenges and priorities-for South Africa (SA) in general and for the three provinces of Gauteng, KwaZulu-Natal (KZN) and Mpumalanga in particular. In keeping with the SHIPP focus, the emphasis is on sexual HIV prevention and the biological, social and structural factors that influence exposure to risk and adoption of HIV prevention methods. Methodology The sources of evidence are limited to published information, gathered through a comprehensive search for research and monitoring reports. Limited research and monitoring data has not in all cases allowed presentation of data at provincial level, but in most instances some data is available and this has been presented.

Objectives Gender-based violence is a global public health crisis, which has health, social, and economic impacts on survivors. In Ghana, responding to and preventing sexual violence on university campuses, has become a priority area. However, data are lacking on the healthcare provider response to students who have experienced sexual violence. The purpose of this study was to conduct a situational analysis to better understand the healthcare provider response to sexual violence in Cape Coast, Ghana. Methods First, an observational facility assessment about healthcare services for survivors of sexual violence was conducted at two hospitals serving university students in Cape Coast, Ghana. Next, healthcare providers at the two hospitals completed: 1) a 113-item questionnaire about healthcare services, knowledge, and attitudes related to sexual violence and 2) indepth semi-structured interviews describing their experiences providing healthcare to survivors of sexual violence. Descriptive statistics and frequencies were computed, and thematic analysis was used to analyze the qualitative data. Results Both sites lacked supplies, including pre-packed rape kits, post-exposure HIV prophylaxis, and informational handouts on medications and support services for survivors. Further, healthcare providers lacked training on gender-based violence, including best practices for caring for survivors and evidence collection procedures. Providers described the clinical management for survivors of sexual violence, including providers' role in reporting sexual

The role and importance of self-care in the continuum of health care are becoming important subjects of debate among social scientists and health professionals. Interest in the self-care component of health services is stimulated by the convergence of diverse pressures common to health services systems. Depersonalized medical care, rising costs of high technology, focus on curative care, growth of lay knowledge, recognition of the limits of medical care, and documentation of the impact of the individual’s health behavior on patterns of morbidity are all factors stimulating new thinking regarding the importance of individuals and families to the effective and efficient functioning of health service systems.

Background: The uptake of findings from sexual and reproductive health and rights research into policy-making remains a complex and non-linear process. Different models of research utilisation and guidelines to maximise this in policy-making exist, however, challenges still remain for researchers to improve uptake of their research findings and for policy-makers to use research evidence in their work. Methods: A participatory workshop with researchers was organised in November 2017 by the Academic Network for Sexual and Reproductive Health and Rights Policy (ANSER) to address this gap. ANSER is a consortium of experienced researchers, some of whom have policy-making experience, working on sexual and reproductive health and rights issues across 16 countries and 5 continents. The experiential learning cycle was used to guide the workshop discussions based on case studies and to encourage participants to focus on key lessons learned. Workshop findings were thematically analysed using specific stages from Hanney et al.'s (Health Res Policy Syst 1:2, 2003) framework on the place of policy-making in the stages of assessment of research utilisation and outcomes. Results: The workshop identified key strategies for translating research into policy, including joint agenda-setting between researchers and policy-makers, as well as building trust and partnerships with different stakeholders. These were linked to stages within Hanney et al.'s framework as opportunities for engaging with policy-makers to ensure uptake of research findings. Conclusion: The engagement of stakeholders during the research development and implementation phases, especially at strategic moments, has a positive impact on uptake of research findings. The strategies and stages described in this paper can be applied to improve utilisation of research findings into policy development and implementation globally.

The role and importance of self-care in the continuum of health care are becoming important subjects of debate among social scientists and health professionals. Interest in the self-care component of health services is stimulated by the convergence of diverse pressures common to health services systems. Depersonalized medical care, rising costs of high technology, focus on curative care, growth of lay knowledge, recognition of the limits of medical care, and documentation of the impact of the individual’s health behavior on patterns of morbidity are all factors stimulating new thinking regarding the importance of individuals and families to the effective and efficient functioning of health service systems.

Background: The sexual and reproductive health (SRH) status of female sex workers is influenced by a wide range of demographic, behavioural and structural factors. These factors vary considerably across and even within settings. Adopting an overly standardised approach to sex worker programmes may compromise its impact on some subgroups in local areas. Methods: Records of female sex workers attending clinic-, community-, or hotel-based health services in Johannesburg (n = 1422 women) and Pretoria (n = 408 women), South Africa were analysed. We describe the population's characteristics and identified factors associated with sexual and reproductive health outcomes, namely HIV status; previous symptomatic sexually transmitted infection (STI); modern contraceptive use and number of child dependents. Results: The women in Johannesburg were less likely than those in Pretoria to have HIV (42.2% vs 52.9%), or previous symptomatic STIs (44.3% vs. 8.3%), and were 1.4 fold less likely to have child dependents (20.1% vs. 15.3%). About 43% of women in Johannesburg were Zimbabwean and 40% in Pretoria. Of concern, only about 15% of women in both sites were using modern contraceptives. Johannesburg women were also more likely to access health services at a hotel (85.0% vs. 80.6%) or clinic (5.7% vs. 0.5%), to have completed secondary education (57.1% vs. 36.0%), and moved house more than twice during the past year (19.6 vs. 2.0%). In both cities, risk of HIV rose rapidly with age (23.8%-58.2% vs. 22.0%-64.8%). Of interest, HIV prevalence was considerably higher in those with consistent condom use with one's main partner than inconsistent users. Conclusions: Sex worker populations are heterogeneous. Local health programmes must prioritise services that reflect the variety and complexity of sex worker needs and behaviours, and should be designed in consultation with sex workers. Segmenting sex worker populations according to age, country of origin and place of service delivery, and training healthcare providers accordingly, could help prevent new HIV infections, improve adherence to antiretroviral treatment and increase uptake of SRH services.

WHO's normative guidance on self-care interventions for sexual and reproductive health and rights (SRHR) promotes comprehensive, integrated and people-centred approaches to health service delivery. Implementation of self-care interventions within the context of human rights, gender equality, and a life course approach, offers an underused opportunity to improve universal health coverage (UHC) for all. Results from an online global values and preferences survey provided lay persons' and healthcare providers' perspectives on access, acceptability, and implementation considerations. This analysis examines 326 qualitative responses to open-ended questions from healthcare providers (n = 242) and lay persons (n = 70) from 77 countries. Participants were mostly women (66.9%) and were from the Africa (34.5%), America (32.5%), SouthEast Asia (5.6%), European (19.8%), Eastern Mediterranean (4.8%), and Western Pacific regions (2.8%). Participants perceived multiple benefits of self-care interventions for SRHR, including: reduced exposure to stigma, discrimination and access barriers, increased confidentiality, empowerment, self-confidence, and informed decision-making. Concerns include insufficient knowledge, affordability, and possible side-effects. Implementation considerations highlighted the innovative approaches to linkages with health services. Introduction of self-care interventions is a paradigm shift in health care delivery bridging people and communities through primary health care to reach UHC. Self-care interventions can be leveraged by countries as gateways for reaching more people with quality, accessible and equitable services that is critical for achieving UHC. The survey results underscored the urgent need to reduce stigma and discrimination, increase access to and improve knowledge of self-care interventions for SRHR for laypersons and healthcare providers to advance SRHR.