Barriers and enablers to acceptance of voluntary counseling and testing (VCT) services by youth males

Williams, Leilanie (2007-03)

Thesis (MPhil)--University of Stellenbosch, 2007.

Thesis

ENGLISH ABSTRACT: Voluntary Counseling and Testing (VCT) is considered an important component of the South African government’s response to the HIV/AIDS pandemic. Despite of this, the numbers of South Africans who have accessed VCT remains low. Pregnant women in antenatal clinics remain the primary recipients of HIV testing since it is routinely offered to them at antenatal clinics. Figures from antenatal clinics constitute the most important source of HIV/AIDS statistics in South Africa. Targeting women at antenatal clinics perpetuate the stereotypes that women are solely responsible for reproductive health issues or, that they are to be blame for the mounting HIV infections. These beliefs exacerbate the culminating violence against women. According to observation, active involvement of male youth in reproductive health at the Rosedale Clinic situated in Uitenhage, a town in the Eastern Cape, appears to be very limited. This might be as a result of traditional beliefs declaring reproductive health a primarily female domain. Active involvement of males in reproductive health is considered to have positive health outcomes both for themselves, and their partners. The purpose of this study is thus to encourage males served by the Rosedale clinic to become more actively involved in one aspect of reproductive health, namely voluntary counseling and testing (VCT). The study aims to find out which factors constitute barriers and enablers to VCT acceptance by male youth. Semi-structured, face-to- face interviews were conducted in September 2006 with eighteen males, 18 to 25 years, to determine from their perspective what constitute barriers and enablers to HIV test acceptance by males. These participants were recruited from two well-known rugby clubs in Uitenhage, located in the Eastern Cape. In addition, a focus group discussion was conducted with four males recruited at a graduate development programme hosted in Uitenhage in order to explore common themes emerging from interviews and the discussion. A pervasive, psychologically rooted fear; and possible low perception of risk emerge from this study as main barriers to HIV testing. Negative perceptions regarding service delivery in the public health sector constitute another barrier to HIV testing. The possibility of teasing, a common phenomenon amongst rugby players but not exclusive to them, exacerbates peer pressure thus possibly contributing to low levels of HIV test acceptance among these males. Increased HIV test acceptance is associated with increased opportunities of exposure to HIV testing opportunities, for example at awareness campaigns. Access to medical aid and income is also associated with an increased likelihood of HIV testing since most males prefer accessing HIV testing services in the private sector. Convenience and ease of access to HIV testing services are important when these males consider going for HIV testing.

AFRIKAANSE OPSOMMING: Vrywillige Berading en MIV Toetsing, een aspek van reproduktiewe gesondheid, word beskou as ‘n belangrike komponent van die Suid-Afrikaanse regering se strategie teen MIV/VIGS. Ongeag van hierdie feit is ‘n groot aantal Suid-Afrikaners nog nie getoets vir MIV nie. Swanger vrouens word op ‘n daaglikse basis hierdie toets aangebied as deel van roetine ondersoeke. Syfers vanaf pre-natale klinieke vorm die hoofbron van Suid- Afrika se HIV/VIGS statistieke. Die feit dat swanger vrouens die hoofteikengroep is vir MIV toetsing dra by tot stereotipes wat daartoe lei dat vrouens primêr verantwoordelik is vir die behoud van reproduktiewe gesondheid; en dat hulle beskou word as die hoofverdagtes in die toenemende oordrag van MIV. Laasgenoemde beskuldiging vererger geweld teen vrouens. Volgens waarneming by Rosedale publieke kliniek geleë in Uitenhage, ‘n dorp in die Oos-kaap, is veral jeugdige mans se betrokkenheid in reproduktiewe gesondheid uiters minimaal. Dit kan moontlik wees omdat reproduktiewe gesondheid tradisioneel as ‘n vroulike domein beskou word. Aktiewe betrokkenheid van beide mans en vrouens in reproduktiewe gesondheid het positiewe gesondheidsuitkomste vir beide partye tot gevolg. Die doel van hierdie studie is dus om jongmans wie deur die Rosedale kliniek bedien word aan te moedig om meer sigbaar te word in reproduktiewe gesondheidskwessies; met die oog op een aspek daarvan naamlik, vrywillige berading en MIV toetsing. Die studie poog dus om uit te vind watter struikelblokke jeugdige mans weerhou van MIV toetsing en; watter faktore mans aanmoedig om vir die toets te gaan. Semi-gestruktureerde, aangesig-tot- aangesig onderhoude is in September 2006 met 18 mans, vanaf die ouderdomme 18 tot 25 jaar, gevoer. Hierdie mans was tydens die studie rugbyspelers vanuit twee welbekende rugbyklubs op die dorp. ‘n Addisionele fokus groep is verder gevoer met manlike studente wie ten tye van die studie aan ‘n ontwikkelingsprogram vir gradueerders deelgeneem het op die dorp. Hierdie fokusgroep is geloods om soortgelyke temas vanuit die onderhoude en die bespreking te ondersoek. Die studie toon dat ‘n diepgewortelde, sielkundige vrees; en moontlike lae bewustheid van persoonlike risiko die twee vernaamste struikelblokke is vir MIV toetsing. Negatiewe sienings rakende die publieke gesondheidssektor kan moontlik bydrae tot weerstand teen MIV toetsingsdienste. Tergery, ‘n bekende verskynsel onder rugbymans, maar nie slegs beperk tot diè groep nie, dra by tot groepsdruk en weerhou moontlik menige mans van MIV toetsing. Diegene in die studie wie alreeds vir MIV getoets is geniet toenemende blootstelling aan MIV toetsingsgeleenthede; bv tydens bewusmakingsveldtogte geloods òf by die werk òf tersiêre instellings. Toegang tot ‘n mediese fonds; en ‘n inkomste is moontlike bepalende faktore sienende dat meeste respondente gesondheidsdienste in die privaatsektor verkies. Gerieflike toegang tot MIV toetsingsdienste word deur sommige mans as belangrike beskou wanneer hulle MIV toetsing oorweeg.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/19894
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