Browsing by Author "Coetzee, Jenny"
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Item Perceptions of counsellors and youth-serving professionals about sexual and reproductive health services for adolescents in Soweto, South Africa(BMC, 2018-02) Mulaudzi, Mamakiri; Dlamini, Busisiwe Nkala; Coetzee, Jenny; Sikkema, Kathleen; Gray, Glenda; Dietrich, Jana JanineBackground: Adolescents in South Africa remain vulnerable to HIV. Therefore, it is crucial to provide accessible adolescent-friendly HIV prevention interventions that are sensitive to their needs. This study aimed to investigate the perceptions of HIV counsellors and other youth-serving professionals about the barriers to providing adolescent youth-friendly sexual and reproductive health services to adolescents in Soweto, South Africa. The study also explored how sexual and reproductive health services in South Africa could be improved to become more accessible to adolescents. Methods: The research team conducted two focus group discussions with HIV counsellors, and 19 semi-structured interviews with youth-serving professionals from organisations working with adolescents. Audio-recorded data were transcribed verbatim and analysed using thematic analysis. Results: The results of the study reveal that counsellors were expected to give adolescents HIV counselling and testing (HCT) but felt restricted by what they perceived as inflexible standard operating procedures. Counsellors reported inadequate training to address adolescent psychosocial issues during HCT. Healthcare provider attitudes were perceived as a barrier to adolescents using sexual and reproductive health services. Participants strongly recommended augmenting adolescent sexual and reproductive health services to include counsellors and adolescents in developing age- and context-specific HIV prevention services for adolescents. Conclusion: Continuous upskilling of HIV counsellors is a critical step in providing adolescent-friendly services.Item Sexual and reproductive healthcare services for female street-and hotel-based sex workers operating from Johannesburg City Deep, South Africa.(2013-08-13) Coetzee, JennySex work is a crime in South Africa. With the prevalence and deleterious social and economic effects of HIV, in health literature sex work has often been understood in relation to the way that it intersects with the transmission of the epidemic. This positioning of sex work then inadvertently stigmatises sex workers who are often cast outside the rights-based discourses that characterise South Africa’s post-apartheid democracy. In order to address this problem, this study explored the perceived barriers and facilitators to sex workers’ accessing sexual and reproductive healthcare (SRHC), gaps in the current service offerings relating to sex worker’s sexual and reproductive health (SRH) and the general experiences of SRHC amongst 11 female sex workers in Johannesburg, South Africa. Semi-structured in-depth interviews were conducted with these sex workers, who were based in Johannesburg City Deep. The resultant data were transcribed and subjected to a thematic analysis. The study shows that various structural and individual level barriers are perceived to prevent access to SRH. In particular, the analysis suggests that the disease-specific focus on sex worker-specific projects poses a barrier to sex workers’ accessing a complete range of SRHC services. Violence enacted by healthcare professionals, police and clients fuelled a lack of trust in the healthcare sector and displaced the participants from their basic human rights. It is also worrying that religion posed a threat to effective SRHC because some religious discourses label sex workers as sinners who are perceived to be excluded from forgiveness and healing. Finally, motherhood proved to be a point at which the participants actively managed their health and engaged with and in broad-based SRHC. Participants frequently only sought SRHC at the point at which an ailment affected their livelihood and ability to provide for a family. Taken together, these findings seem to show a range of formidable challenges to sex workers’ understanding of themselves in a human rights discourse. This study’s findings are of particular importance to rethinking the legislation that criminalises sex work, as well as healthcare initiatives geared both towards sex workers and women in general.