8th International Conference on Urban Health
Health-seeking behavior and access to HIV treatment among migrants in the Inner City of Johannesburg, South Africa
Brigitte Bagnol, Brian Ng’andu, Nedson Pophiwa, Nyoni Phefumula Nyaninge, Celso Inguane, Anne Simon, Zukiswa Fipaza, Edwin Maroga, and Andrew Karlyn
The Population Council, funded by the Ford Foundation, conducted research to understand the health-seeking behavior of migrants in Yeoville, Berea, and Hillbrow in the Inner City of Johannesburg. These neighborhoods are mainly occupied by large migrant populations from various African countries and are characterized by dense population, poor infrastructure, few social services, high HIV prevalence, and high rates of crime. The study, conducted from March 2008 to March 2009, includes qualitative and quantitative research methods. The qualitative methodologies used included: ethnography, key informant interviews (16), focus group discussions (14) and in-depth interviews (11). Interviews included women and men drawn from different ages, nationalities, neighborhoods, and histories. For quantitative research methods, a structured questionnaire was developed. Four-stage multi-cluster sampling was used. Of the 597 respondents randomly selected, the majority were cross-border migrants (56.8%) as compared to 43 percent born in South Africa. The average age was 30 years, and 58 percent were female. Within the migrant population, public health hospitals are the most frequently used services (40%) followed by public clinics (33%) and private clinics or doctors (28%). The majority of respondents were aware of their HIV status (62%). The study also shows inconsistent condom use, with approximately 39 percent of the respondents engaging in unprotected sex with partners other than their main partner. Cross-border migrants face language barriers and complained about the behavior of health practitioners such as xenophobic tendencies and corruption. There is evidence that there are several challenges in relation to access to HIV treatment. These are a result of the lack of information among health care providers about the needs of migrants. Further research is needed to address diverse cultural issues among clinical staff in these key communities. There is also a need to build awareness among migrants and clinical staff to ensure constitutional rights are upheld.
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