Two days' training enough to make medics pro-gay: expert

Many health workers admit that their religious and cultural beliefs prejudice them against gay patients.

But a team of HIV experts in Western Cape found that just one or two days' training were enough to transform attitudes.

"The view was that the training resulted in a positive shift towards increased sensitivity and acceptance of men who have sex with men (MSM) and the diversity of human sexuality," said Andrew Scheibe, writing in the SA Journal of HIV Medicine.

Scheibe and colleagues from the Desmond Tutu HIV Centre at the University of Cape Town provided training to 592 health workers, and found that their overall knowledge about gay men improved by 10%.

But it was their attitudes that shifted most. One of the workers told a focus group that when she saw gay sex on TV before the training, "I nearly vomited ... I was like, 'dear god, what is going on, what are these men doing?' ... After the training I was more open-minded and more comfortable."

Some health workers said they found the training challenging, shocking and in conflict with their beliefs.

Evaluating the sessions, one wrote: "I liked the fact that the workshop did not try to change my perceptions," while another told a focus group: "I've come to realise that behind closed doors you can do whatever ... and I accept the person's choice."

Scheibe said the training uncovered moralising and homophobic attitudes.

"It is imperative that healthcare providers distinguish between their right to hold beliefs and their professional obligation to render services free of discrimination."

He admitted that the training alone was unlikely to shift practices at hospitals and clinics. "It needs to be accompanied by institutional changes, including provision of tools that health workers can use to implement the new knowledge."

These included gender-neutral reproductive health assessment forms. Without such tools "questions relating to sexuality and anal sex will not be asked, thus hampering effective service provision".

WHO ARE MSM?

The Joint UN Programme on HIV and Aids defines MSMs as "males who have sex with males, regardless of whether or not they also have sex with women or have a personal or social gay or bisexual identity".

Andrew Scheibe and his colleagues say that grouping "sub-populations" of MSM limits the appropriateness of healthcare approaches.

"In South Africa, MSM have a range of gender expressions, gender identities and sexual practices. Moreover, certain characteristics may change over time or by circumstance.

"Yet, gay-identifying males and less 'visible' heterosexual and bisexual MSM exist in South Africa, where constitutional protection conflicts with widespread homophobia."