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

Zoe Duby,Benjamin Brown,Busisiwe Nkosi,Francisco Fong-Jaen,Andrew Scheibe

doi:10.4102/sajhivmed.v20i1.909

Abstract

BackgroundSensitisation 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.ObjectivesThe 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.MethodsThis 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.ResultsThe 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.ConclusionThe 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.

Highlights

75% (n = 302) of respondents were aware that sex workers, men who have sex with men (MSM) and people who use drugs (PWUD) are more likely to be exposed to violence than the general community, compared to 59% (n = 235) prior to training
83.5% of trainees (n = 338) agreed that this training increased their awareness of how stigma affecting sex workers, MSM and PWUD can limit their access to effective healthcare, compared to 69% (n = 276) prior to the training
In the post-training assessments, 67% (n = 273) of trainees felt that it was important for their health services to be friendly towards and supportive of sex workers, MSM and PWUD, compared to 50% (n = 202) prior to the training

Summary

Introduction

In the South African context, MSM, sex workers and PWUD report frequent exclusion from society and high levels of stigma and discrimination in the healthcare setting.[6,8,9,13,14] Judgemental http://www.sajhivmed.org.za. 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’, men who have sex with men, sex workers and people who use drugs, through the sensitisation of healthcare workers

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Methods

Results

Discussion

Conclusion