BackgroundHomosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate health care. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk.Aim of the studyThe aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC) services in Umlazi in the province of KwaZulu-Natal (KZN).MethodA qualitative, exploratory, descriptive study was conducted which was contextual in nature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis.ResultsTwo major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel.ConclusionParticipants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes.

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Background: Comprehensive Primary Health Care (PHC), based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans. Objectives: Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients’ experiences led to satisfaction or dissatisfaction with the Fast Queue service.Method: A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed.Results: Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources.Conclusion: Effective health communication strategies contribute to positive experiences by health care users and these can be effected by: (1) involvement of health care providers in planning the construction of health facilities to give input about patient flow, infection prevention and control and provision of privacy, (2) effective complaints mechanisms for users to ensure that complaints are followed up and (3)encouraging users to arrive at the facility throughout the day, rather than the present practice where all users arrive at the clinic early in the morning.

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Background: People with HIV (PWH), who engage in regular physical activity, have improved fitness, muscular strength, body composition, health-related quality of life and mental health symptoms, but PWH have amongst the lowest physical activity levels of those with any chronic health condition. Furthermore, there is scant evidence examining these relationships in PWH in Africa.Aim: To address these critical gaps, this cross-sectional descriptive research study examined the relationships between demographic, HIV-related, anthropometric factors, neighbourhood walkability and physical activity, amongst PWH in Durban, South Africa.Setting: Respondents (N = 100) were receiving primary healthcare in six eThekwini nurse-run municipal clinics.Methods: Self-reported socio-demographic data were collected, and HIV-related medical data were extracted from respondent’s medical charts. Height and weight were measured to calculate the body mass index (BMI, kg/m2); neighbourhood walkability was measured on the Neighbourhood Environment scale; and physical activity, specifically functional exercise capacity, was measured by the 6-min walk test (6MWT).Results: On average, respondents were black African, female, approximately 38 years old and unemployed; men were of normal weight whilst women were overweight. Only 65% of the respondents reached the age- and sex-predicted distance during the 6MWT. Correlational analyses did not reveal any significant relationships between the functional exercise capacity and socio-demographic, HIV-related factors or anthropometric measures.Conclusion: South African PWH do not reach their predicated walking distance on the 6MWT. Engaging community agencies to promote walking as both a means of transportation and leisure physical activity may decrease the risks of a sedentary lifestyle and improve progression towards recommended physical activity targets.