Structural barriers and facilitators to accessing HIV services for marginalized working populations: Insights from farm workers in South Africa.

Autor:	Mlangeni N; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.; Division of National Health Laboratory Services, National Institute for Occupational Health, Johannesburg, South Africa., Lembani M; School of Public Health, University of Western Cape, Cape Town, South Africa., Adetokunboh O; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.; DSI-NRF Centre of Excellence for Epidemiological Modelling and Analysis, Stellenbosch University, Cape Town, South Africa.; The University of the People, Pasadena, CA, USA., Nyasulu PS; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.; School of Public Health, University of the Witwatersrand, Division of Epidemiology and Biostatistics, Faculty of Health Sciences, Johannesburg, South Africa.
Jazyk:	angličtina
Zdroj:	Health policy and planning [Health Policy Plan] 2024 Oct 26. Date of Electronic Publication: 2024 Oct 26.
DOI:	10.1093/heapol/czae098
Abstrakt:	Farm workers are a vulnerable working population that face significant inequalities in accessing health services, including those for HIV prevention, treatment, and care. This descriptive phenomenological study aimed to explore farm workers' experiences when accessing HIV services, and was conducted in Limpopo province, South Africa. Eighteen in-depth interviews (IDIs) were conducted in four health facilities from two districts, and two focus group discussions (FDGs) were conducted in one of the farms within the province. Purposive and systematic random sampling were used to select study participants. A deductive thematic approach was used to analyze data, informed by the social-ecological model of health. The results reveal that farm workers perceive multiple interdependent factors that inhibit or enable their access to HIV healthcare services. Key barriers to HIV healthcare were transport affordability, health worker attitudes, stigma and discrimination, models of HIV healthcare delivery, geographic location of health facilities, and difficult working conditions. Key facilitators to HIV healthcare included the availability of mobile health services, the presence of community health workers, and a supportive work environment. The findings suggest disparities in farm workers' access to HIV services, with work being the main determinant of access. We, therefore, recommend a review of HIV policies and programs for the agricultural sector, and models of HIV healthcare delivery that address the unique needs of farm workers. (© The Author(s) 2024. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu