The willingness of tavern and shebeen owners in Gqebera, Port Elizabeth to implement or strengthen existing HIV prevention efforts and measures in their establishments

Douglas-Jones, Isobel M (2014-06-03)

Thesis (MPhil)--Stellenbosch University, 2014.

Thesis

ENGLISH ABSTRACT: Socio-economic conditions prevailing in Gqebera, Port Elizabeth, give rise to many challenges facing the community, including high alcohol use and a high HIV prevalence. Tavern and shebeen owners are uniquely positioned to play a possible role in HIV prevention efforts in their liquor serving establishments as they are obvious intermediaries between alcohol abuse and possible HIV transmission (which could result because of unprotected sex where one partner is HIV-positive). The overall aim of the research was therefore to explore the willingness of tavern and shebeen owners in Gqebera to implement or strengthen existing HIV prevention efforts and measures at their establishments. The study was exploratory in nature. Semi-structured interviews with eleven tavern and shebeen owners in Gqebera, both male and female, were conducted. In depth interviews with two key respondents to provide contextual information about the legal and socio-economic environment in which liquor serving and selling establishments operate were also done. The research findings indicated a high degree of concern among the tavern and shebeen owners interviewed about the possible transmission of HIV among customers and in the community. This concern also reflected in the high level of willingness to implement or strengthen HIV prevention efforts and measures in their establishments. Condoms, generally available in the establishments, were seen by all owners as central to prevention efforts both for patrons and the wider community. However, owners felt that the distribution of condoms needed to be strengthened. Owners indicated their own need for empowerment and knowledge of referral services available so that they could effectively be counsellors on HIV prevention for their clients. Respondents felt that educational materials have an important role to play. Outside support in various forms to aid prevention efforts, such as in providing training for customers, would generally be welcomed, but potential customer reaction was mentioned as an important factor to be considered in this regard. The main conclusion emanating from this study is that the willingness of tavern and shebeen owners to be involved in HIV prevention should be maximally harnessed as a valuable resource in the fight against HIV and AIDS. The study also revealed many possibilities, and the need, for further research around the topic and related topics. This included the potential for self-regulation by owners of establishments, the provision of incentives for owners to abide by the law, and the role taverns and shebeens could play in reducing Foetal Alcohol Spectrum Disorders and HIV stigma. The study also gave rise to various recommendations directly or indirectly related to the research findings. These include promoting the female condom, the formation of partnerships between establishment owners themselves and with other stakeholders, and for clinics to better manage issues around the identification and stigmatisation of HIV+ patients.

AFRIKAANSE OPSOMMING: Die Gqebera gemeenskap van Port Elizabeth staar vele uitdagings in die gesig vanweë die sosio-ekonomiese toestande wat tans daar heers. Hierdie uitdagings sluit onder andere in alkoholmisbruik en ‘n hoë MIV prevalensie. Taverne en sjebien eienaars is in ‘n unieke posisie om ʹn moontlike rol te speel in die voorkoming van MIV-oordrag in hulle besighede aangesien hulle as duidelike tussengangers kan optree tussen alkoholmisbruik en moonlike MIV-infeksie (as gevolg van onbeskermed seks waar een seksmaat MIV-positief is). Die doel van hierdie navorsing was dus om die bereidwilligheid van taverne en sjebien eienaars in Gqebera om bestaande of nuwe MIV voorkomingsmaatreëls op hul besigheidpersele te versterk of te implementer,te evalueer. Hierdie studie was ondersoekend van aard. Semi-gestruktureerde onderhoude met elf taverne en sjebien eienaars in Gqebera, beide manlik en vroulik, is gedoen. In-diepte onderhoude is ook met twee sleutel deelnemers gedoen om kontekstuele inligting rondom die wetlike en sosio-ekonomiese omgewing waarbinne hierdie instellings besigheid doen, in te win. Die studie het bevind dat daar groot kommer onder taverne en sjebien eienaars heers oor die moontlike verspreiding van MIV onder hulle kliënte asook in die gemeenskap. Hierdie besorgdheid is ook weerspieël in die hoë vlakke van bereidwilligheid van eienaars om MIV voorkomingsmaatreëls in hulle instellings te versterk of te implementeer. Deelnemers het gevoel dat kondome, wat tans geredelik beskikbaar is in deelnemers besighede, ‘n belangrike rol speel in die voorkoming van MIV onder hulle kliënte en die breë gemeenskap, maar dat die verspreiding daarvan meer effektief kan wees. Taverne en sjebien eienaars het die behoefte uitgespreek om bemagtig te word oor MIV kwessies sowel as om meer inligting te bekom oor MIV-verwante ondersteuningsdienste waarna hulle hul kliënte kan verwys. Deelnemers het ook gevoel dat MIV-verwante opvoedkundige material ‘n belangrike rol kan speel in hul besighede. Eksterne hulp in die vorm van bv. opleidingssessies is verwelkom, maar deelnemers het ook gewaarsku dat kliënte se sienings hieroor inaggeneem moet word. Die bereidwilligheid van taverne en sjebien eienaars om betrokke te raak in MIV voorkoming kan as ‘n waardevolle hulpbron in die stryd teen MIV/VIGS aangewend word. Die studie het ook vele moontlikhede vir verdere navorsing geïdentifiseer, insluitend die potensiaal vir self-regulering deur eienaars; om inisiatiewe van stapel te stuur om eienaars aan te moedig om binne die wet op te tree; en die rol wat taverne en sjebien eienaars kan speel in die vermindering van Fetale Alkohol-spektrumsteurings en van MIV stigma. Verskeie aanbevelings, wat direk of indirek voortspruit uit hierdie studie se bevindinge, sluit in: Bewusmaking rondom die gebruik van vroulike kondome, die bevordering van beter samewerking tussen taverne en sjebien eienaars en ander rolspelers,

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