Exploring the development and implementation of health and support services in five South African higher education institutions for a key population, men who have sex with men

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Date
2017
Authors
Alves, Sianne Maria
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University of the Free State
Abstract in other languages 𝘚𝘤𝘳𝘰𝘭𝘭 𝘥𝘰𝘸𝘯 𝘧𝘰𝘳 𝘈𝘧𝘳𝘪𝘬𝘢𝘢𝘯𝘴
Abstract
𝑬𝒏𝒈𝒍𝒊𝒔𝒉 The need for university support of self-identifying students has received recent attention with the introduction of global funding and directives from the National Department of Health through the National Strategic Plan (2012-2016). Previous HIV prevention programmes funding provided hardly any to no support for self-identifying populations in specific HIV prevention programmes, with the result that structural discrimination reinforced hegemonic norms that constrained the “health, opportunities and resources of [already] socially stigmatized individuals” (Storholm et al., 2013 p.8). Being the only study, as at 15 January 2015, to focus on institutional programmes for men who have sex with men students (MSM) in higher education, my PhD contributes to a gap in knowledge and HIV prevention responses within the university setting. The research reviews five university programmes that were developed to provide biopsychosocial responses for self-identifying students at university. The findings contribute towards praxis that seeks to serve and support populations that experience more than one form of oppression. Applying a critical theorist approach, I conducted ten two hour qualitative interviews with programme coordinators working at five South African universities, to identify the methods they used to locate and retain MSM students within systems of health and support. Furthermore, through the analysis of the data, I analyse the unique approaches that are used in their combined prevention programmes for MSM students in higher education institutions. These approaches include innovations for locating MSM; social media use; structural change; health innovations; and psychosocial changes that focus on creating an enabling environment for sexually diverse students in the higher education setting. As a critical theorist, I question the location of power and how the five programme coordinators navigated the university terrain in order to seek support and establish a contentious programme for self-identifying students in university. The results demonstrate that institutional support can be located within the various echelons of the university, which ultimately contests the power held by the executive management. Further findings question the role of academia in institutional programmes and calls for equality in the provision of health and related services for self-identifying students in higher education institutions. Despite South Africa having an advanced Constitution and higher education system, there is much more work to be done, in the training of health care practitioners who are mandated through National policy, to create an inclusive health care environment. Similarly, universities as sites of academic freedom, seemingly fail to uphold the equal protection and implementation of students’ right to sexual orientation and in so doing reinforce heteronormative practices that further discriminate and alienate self-identifying students in university - which results in the limited uptake of HIV prevention and support services in university. My PhD research contributes towards the gap in knowledge that articulates the changes required in higher education institutions that would enhance combined prevention programmes for MSM and sexually diverse populations at university. ___________________________________________________________________
𝑨𝒇𝒓𝒊𝒌𝒂𝒂𝒏𝒔 Self-geïdentifiseerde studente se behoefte aan ondersteuning vanaf die universiteit het onlangs aandag gekry met die instelling van globale befondsing en die Nasionale Departement van Gesondheid se riglyne soos vervat in die Nasionale Strategiese Plan (2012 – 2016). Vorige MIV-voorkomingsprogramme se befondsing het weinig of geen ondersteuning gebied aan self- geïdentifiseerde populasies van spesifieke MIV-voorkomingsprogramme, met die gevolg dat strukturele diskriminasie heersende norms versterk het met betrekking tot die “gesondheid, geleenthede en bronne van individue wat [alreeds] ʼn sosiale stigma het.” (Storholm et al., 2013 p.8). Tot op 15 Januarie 2015 is hierdie die enigste studie in hoër onderwys wat gerig is op institusionele programme vir mans wat seks het met mansstudente (MSM) en my PhD lewer ʼn bydrae tot die leemte in MIV-voorkomingsresponse binne die universiteitsopset. Die navorsing beoordeel vyf universiteitsprogramme wat ontwikkel is om op biopsigesosiale vlak antwoorde vir self-geïdentifiseerde studente op die kampus te bied. Die bevindinge dra by tot praktyke wat daarop ingestel is om populasies wat meer as een vorm van onderdrukking ondervind, te bedien en ondersteun. Deur ʼn kritiese teoretikusbenadering het ek tien twee-uur kwalitatiewe onderhoude gelei met programkoördineerders by vyf Suid-Afrikaanse universiteite om die metodes te identifiseer wat hulle gebruik het om MSM-studente op te spoor en binne die gesondheid- en ondersteuningstelsels te behou. Verder het ek deur die analise van die data die unieke benaderings geanaliseer wat gebruik is in hulle gekombineerde voorkomingsprogramme vir MSM-studente op kampus. Hierdie benaderings sluit in innoverings om MSM-studente op te spoor; die gebruik van sosiale media; strukturele verandering, gesondheid innoverings en sielkundig-sosiale verandering wat fokus op die skep van ʼn gunstige klimaat vir seksuele diversiteit van studente in die hoër onderwysopset. As kritiese teoretikus bevraagteken ek die magsetel en hoe die vyf programkoördineerders deur die universiteitsterrein beweeg het om ondersteuning te soek en omstrede programme te skep vir self-geïdentifiseerde studente op kampus. Die resultate toon dat institusionele ondersteuning gevind kan word binne die verskillende vlakke van die universiteit, wat uiteindelik die mag betwis van die uitvoerende bestuur. Verdere bevindings bevraagteken ook die rol van akademici in institusionele programme en vra vir gelykheid in die voorsiening van gesondheid en verwante dienste wat aan self-geïdentifiseerde studente in hoër opvoedkundige instansies gebied word. Ondanks die feit dat Suid-Afrika ʼn gevorderde Konstitusie en hoër onderwysstelsel het is daar heelwat meer werk om te doen in die opleiding van gesondheidsorgpraktisyns wat deur die Nasionale beleid ʼn mandaat het om ʼn insluitende gesondheidsorg omgewing te skep. Enersyds blyk dit asof universiteite wat plekke van akademiese vryheid is faal in die handhawing van gelyke beskerming en implementering van studente se regte tot seksuele oriëntasie. Hierdeur word heteronormatiewe praktyke versterk wat lei tot verdere diskriminasie en vervreemding van self-geïdentifiseerde studente op kampus – wat weer ʼn beperkte deelname aan MIV-voorkoming op kampus tot gevolg het. My PhD-navorsing dra by tot die leemte in kennis wat die veranderinge verwoord wat nodig is in hoër onderwysinstansies en wat gekombineerde voorkomingsprogramme sal versterk vir MSM en seksuele diversiteit van populasies op universiteit. ___________________________________________________________________
Description
Thesis (Ph.D. (Higher Education Studies))--University of the Free State, 2017
Keywords
University, Inclusive, Institutional-programmes, Sexual-diversity, Health, Support services, Higher education, Transformation, Men-who-have-sex-with-men, HIV infections -- Prevention
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