OUT LGBTI Well-being is dedicated to the building of healthy empowered lesbian, gay, bisexual, transgender and intersex communities in South Africa and internationally. OUT wants to reduce heterosexism and homophobia/transphobia in society. OUT works towards lesbian, gay, bisexual, transgender and intersex peoples’ physical and mental health and related rights and has been in existence for almost 20 years.
Based in Tshwane, OUT’s work takes place on local, provincial, national, continental and international levels. OUT’s focus areas of work are direct health and mental health services, research, sensitisation training of mainstreaming service providers and advocacy.
Given inadequate mainstream service provision, OUT provides direct health and mental health services to LGBTI clients. It includes targeted HIV/AIDS work, direct health services at the OUT Clinic, provision of barrier methods, a telephonic counselling, online counselling, face-to-face counselling, community building programmes, and a youth support group.
When it comes to mainstream service providers, very few of them are aware of the needs and circumstances of members of the LGBTI community and they sometimes even refuse the provision of services. Mainstream service providers very rarely provide appropriate services (such as targeted HIV messaging), are unable to provide relevant LGBTI materials to their LGBTI clients, and often their policies do not include the interests of LGBTI people.
Existing literature shows that accessing sexual health services remains a sensitive issue for clients. Concerns include not only the outcome of the consultation, but the consultation process itself. Mainstream clinics are perceived as a place where clients become mere numbers.
Research has indicated that many of the clients’ concerns are addressed by smaller clinics by providing intimate, private and confidential services. How does a smaller stand-alone clinic encourage the experience of anonymity whilst offering a highly personalised service?
In 2012 OUT undertook a research surveillance study (self-completion questionnaire), which is still on-going, in collaboration with researchers from the UNISA Department of Psychology, Professor Vasi van Deventer and Mr Sean Hagen.
The study was undertaken to establish:
• Biographical and socio-economic profile of clients;
• Why clients visited the OUT clinic specifically;
• What sexual practices and health risk behaviours they engaged in;
• The clients’ healthcare history; and • The preference of clients with regard to healthcare providers.
Preliminary findings from the research which included data from 78 respondents and presented at the South African AIDS Conference in Durban in June focused on two aspects: 1. The kind of service provider preferred; and 2. The reason for selecting a service provider. The researchers concluded that anonymity was less about being anonymous within a system and more about feeling safe within the system. Clients want to feel welcomed and accepted within a clinic that felt like a community, a community with strong and clearly demarcated boundaries.
Most research participants preferred a standalone MSM (Men-who-have-sex-with-men) clinic (40%), 30% preferred a private clinic and only 10% selected a government clinic as a preferred service provider.
Reasons for selecting a preferred service provider included:
• The opportunity to be open about sexual behaviour (70%);
• Appropriate medical advice (55%); and
• Quality of service (50%)
Clients consulted at the OUT clinic said the interface was comfortable, relaxed, warm, accessible, at ease, friendly and they felt at home; the interaction, was efficient, helpful, caring, understanding, encouraging and ensuring; and the relationship established was open and professional.
CONCLUSION / WAY FORWARD
Future planning based on the research findings include:
• Continuation of competent direct health and mental health services to sexual minorities;
• Up scaling of current services provided by the OUT clinic based on data related to current sexual practices and health risk behaviours; and
• Up scaling of prevention, treatment and care interventions based on clients’ sexual practices, risk-taking behaviours and needs