Building self-advocacy in HIV care: the use of role-play to examine healthcare access for HIV-positive MSM in rural South Africa

Glob Health Promot. 2021 Sep;28(3):32-40. doi: 10.1177/1757975920974008. Epub 2020 Dec 10.

Abstract

There is high HIV prevalence and low rates of viral suppression for men who have sex with men (MSM) in South Africa, with few MSM-centered interventions to address these outcomes along the HIV treatment cascade. Participatory interventions may support community building among HIV-positive MSM through which they can share approaches of self-advocacy that are contextually grounded. We conducted a pilot study to assess the use of role-plays in influencing social isolation while also updating our understanding of MSM healthcare experiences in Mpumalanga, South Africa. The study was conducted with 21 MSM leaders who were HIV-positive. There were three groups of seven participants each who created and performed role-plays based on their healthcare experiences, with a focus group discussion (FGD) conducted afterward. Audio-recordings were transcribed, translated, and analyzed using a constant comparison approach. We found that MSM described role-play as cathartic and a future HIV care educational tool for other MSM, and that they outlined points of self-advocacy during HIV care in clinics. Our study suggests that future research should utilize role-play so to integrate contextual factors influencing HIV treatment, especially in high HIV prevalence settings.

Keywords: HIV care; Men who have sex with men (MSM); South Africa; coming out; role-play.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • HIV Infections* / epidemiology
  • HIV Infections* / therapy
  • Health Services Accessibility
  • Homosexuality, Male
  • Humans
  • Male
  • Pilot Projects
  • Sexual and Gender Minorities*
  • South Africa / epidemiology