Browsing by Author "Muller, Alexandra"

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    Open Access
    Attitudes, knowledge and beliefs around homosexuality: exploring the views of 5th year medical students
    (2016) Sopitshi, Athenkosi; Muller, Alexandra; Colvin, Christopher J
    Introduction: Discrimination from health workers has been found to be a deterrent for lesbian, gay, bisexual and transgender (LGBTI) people seeking healthcare. Despite these findings, LGBTI-focused healthcare remains understated in medical training and university curricular. Learning about medical students' attitudes can provide useful ways of identifying interventions to capacitate health professionals to address LGBTI health. Methods: This study is a mixed methods study, data were collected using a 25 item homophobia scale with additional questions designed for the South African context, and focus group discussions with semi-structured questions. Results: 157 Medical students in the 5th year class at a university in the Western Cape, South Africa completed the survey, 20 of them formed part of three focus group discussions. Outcomes showed significant gaps in student's curriculum in the area of LGBTI health which influenced their lack of knowledge and preparedness. Considering that homophobia and heterosexism remain widespread in the students' contexts, the findings point to generally favourable views of LGBTI people. In this respect, two thirds of the participants indicated that they are not bothered by seeing same-sex partners together and 64% felt that homosexuality was not immoral and showed support for LGBTI rights. The qualitative findings indicate that a contributing factor in shifting their attitudes based on their own perspectives was a change in environments from their hometowns to university. Students showed a keen interest in early integration of LGBTI health in their curriculum which is encouraging. Conclusion: Medical training needs to be responsive and intentional about addressing student attitudes towards LGBTI people, as this has implications on the students' perceived competency and affects the quality of healthcare they deliver.
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    Open Access
    Making the invisible visible: a systematic review of sexual minority women’s health in Southern Africa
    (BioMed Central, 2016) Muller, Alexandra; Hughes, Tonda L
    Background: Over the past two decades research on sexual and gender minority (lesbian, gay, bisexual and transgender; LGBT) health has highlighted substantial health disparities based on sexual orientation and gender identity in many parts of the world. We systematically reviewed the literature on sexual minority women’s (SMW) health in Southern Africa, with the objective of identifying existing evidence and pointing out knowledge gaps around the health of this vulnerable group in this region. Methods: A systematic review of publications in English, French, Portuguese or German, indexed in PubMed or MEDLINE between the years 2000 and 2015, following PRISMA guidelines. Additional studies were identified by searching bibliographies of identified studies. Search terms included (Lesbian OR bisexual OR “women who have sex with women”), (HIV OR depression OR “substance use” OR “substance abuse” OR “mental health” OR suicide OR anxiety OR cancer), and geographical specification. All empirical studies that used quantitative or qualitative methods, which contributed to evidence for SMW’s health in one, a few or all of the countries, were included. Theoretical and review articles were excluded. Data were extracted independently by 2 researchers using predefined data fields, which included a risk of bias/quality assessment. Results: Of 315 hits, 9 articles were selected for review and a further 6 were identified through bibliography searches. Most studies were conducted with small sample sizes in South Africa and focused on sexual health. SMW included in the studies were racially and socio-economically heterogeneous. Studies focused predominately on young populations, and highlighted substance use and violence as key health issues for SMW in Southern Africa. Conclusions: Although there are large gaps in the literature, the review highlighted substantial sexual-orientationrelated health disparities among women in Southern Africa. The findings have important implications for public health policy and research, highlighting the lack of population-level evidence on the one hand, and the impact of criminalizing laws around homosexuality on the other hand.