“To combat HIV/Aids, we need to talk about anal sex or anal smears as normally as we talk about vaginal sex or vaginal smears. We need to accept without bias or judgement what sex involves for lesbian, gay, bisexual, trans and intersex (LGBTI) individuals in the same way that we do for heterosexual partners. As we prepare for World Aids Day, the right to acceptance, tolerance and equality must take precedence in our healthcare environment,” says Dr Sello Mashamaite, RIGHT TO CARE’S head of South Africa’s largest HIV/Aids clinic.
RIGHT TO PRIDE, an initiative of Right to Care, which focuses on ensuring LGBTI individuals are fully accepted in clinics and facilities. In partnership with the Department of Health and Helen Joseph hospital through Thembalethu Clinic, Right to Care wants to deliver inclusive, rights-based and gender sensitive services.
It trains and sensitises health care professionals to eliminate any personal negative sentiments towards LGBTI patients. It empowers them to ask the right questions so LGBTI individuals can offer their answers without fear of shame, and in turn, be provided with the right treatment.
“If information about patients is compromised, the clinical response will be too. We are not going to eliminate HIV/Aids if this scenario is not addressed,” says Mashamaite. “Fear of stigmatisation still prevents many people from identifying themselves as lesbian, gay, bisexual or transgender. Many do not seek healthcare at all because of prior negative experiences.”
Right to Pride embraces diversity amongst staff and clients. Right to Care’s staff of almost 2000 includes LGBTI staff who bring knowledge and experience from their backgrounds which can be harnessed to improve service delivery. They help to better engage with hard to reach key population groups. Right to Pride is completing an LGBTI sensitisation programme within the organisation and thereafter expanding to other public service organisations.
As well as the Department of Health, these will include the Department of Home Affairs that for instance currently only caters for male and female only and does not accommodate transgender people, as well as the departments of Social Development and Education.
Craig Chapman, on behalf of Right to Pride says, “We cannot afford to think of sex in a silo way as it is only damaging South Africa’s response to the HIV epidemic. Segregating migrant workers, drug users, sex workers, clients of sex workers, prisoners, the LGBTI community, men who have sex with men or heterosexuals from anyone else living with or exposed to HIV/Aids is not helpful. It has curbed the effectiveness of treatment, management and care for too long. The LGBTI community is as different and as diverse as any other population. It knows no boundaries and is not limited to any culture, race or geographic boundary.”
Chapman says, “Furthermore, anal sex is not just gay and male to male sex. A high percentage of heterosexual couples have anal sex. This is critical in the healthcare context as anal sex is also the riskiest for HIV transmission because of limited cell thickness and lack of lubrication in the anus.”
“This is why Right to Pride focuses on ensuring healthcare staff ask the right questions, for example – what kind of sex are you having?”
Information about HIV prevention and treatment also tends to focus on heterosexuals, especially women and mothers, and excludes the LGBTI community.