‘We must treat them like all the other people’: Evaluating the Integrated Key Populations Sensitivity Training Programme for Healthcare Workers in South Africa

Abstract

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 non-judgemental 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 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.

Using structural equation modelling to characterise multilevel socioecological predictors and mediators of condom use among transgender women and cisgender men who have sex with men in the Philippines

“…There is emerging evidence showing positive effects of antidiscrimination structural interventions and professional trainings. 73–75 The findings of this study, therefore, point to structural gaps in HIV prevention policy strategies and programmatic trainings that could potentially address environmental barriers to condom and HIV prevention services among trans-WSM and cis-MSM communities in the Philippines.…”

Cultural and clinical challenges in sexual health care provision to men who have sex with men in Tanzania: a qualitative study of health professionals’ experiences and health students’ perspectives

“…Across most of Africa, key populations face discrimination, judgements, and negative attitudes from health care workers. These factors act as barriers in accessing healthcare services by lesbian, gay, bisexual and transgender (LGBT) populations [27,38,39]. Furthermore, same sex relationships in sub-Saharan Africa are heavily stigmatized and criminalized in many countries in the continent [40,41].…”

Healthcare worker training to improve quality of care for sexual and gender minority people in sub‐Saharan Africa: learning from efforts in Uganda

“…Evaluation of the initiative is currently underway, including data collection on processes of training and capacity building, outcomes related to programmatic and service improvements, impact on HIV‐related clinical outcomes and qualitative interviews to further elucidate facilitators of and barriers to implementation. While results from Uganda are forthcoming, previous evaluations of SGM health‐focused training programmes in sub‐Saharan Africa offer encouragement: healthcare worker trainings in both Kenya and South Africa on sexual health needs of MSM were associated with increases in the necessary knowledge and decreases in negative attitudes [50‐52].…”