The communicative role played by social workers in the introduction and uptake of oral pre-exposure prophylaxis(oral prep) in Vulindlela.

Abstract

Since the discovery of HIV and Aids many efforts to reduce the spread of the virus have been taken, these include biomedical interventions such as male circumcision, male and female condoms and PrEP. Several HIV prevention methods have been effective to curb the spread of HIV infections, with Voluntary Male Medical Circumcision (VMMC) and PrEP, have shown impact in overall reduction of HIV transmission. (Moodley, et al., 2016). PrEP has been shown to reduce the risk of HIV infection from unprotected sex by over 90 percent, and from injecting drugs by more than 70 percent (CDC, 2019). Biomedical interventions have been shown to be more effective when implemented in conjunction with behavioral interventions, and where contextual factors such as cultural context are considered in the implementation of such interventions (Baxter & Karim, 2016) A key factor that surfaces from the various studies considered here is that, biomedical interventions have less efficacy when used independently but works best with behavioral interventions rooted in various social and cultural contexts of those targeted. Such behavioral interventions including peer education, mass media communication, school-based sex education programmes, socioeconomic interventions and behavioural counselling, have opened up a greater scope for clinical social work in South Africa, and have been demonstrated to be instrumental in targeted awareness among adolescents and young adults (Baxter & Karim, 2016; AVERT, 2019; Morojele, et al., 2006). Biomedical HIV prevention technologies, such as antiretroviral pre‐exposure prophylaxis (PrEP) hold huge potential to substantially reduce HIV acquisition in high‐risk populations globally (Giovenco, 2019). Although many people who could benefit from PrEP are still unaware of its existence hence the need for social workers to raise awareness through education and interventions directed at sociostructural change in the communities. This dissertation provides an understanding of the communicative role played and can play by social workers in the future uptake and introduction to HIV prevention methods in Vulindlela. This study investigates the level of knowledge amongst social workers working with HIV clients. By employing a culture-centred approach (CCA) and the Social Ecology Model of communication and Health Behaviour (SEMCHB), this dissertation seeks to reach a holistic understanding of how social workers communicate with their clients about HIV prevention methods and their level of knowledge about HIV prevention methods such as PrEP. A phenomenological approach was adopted for this research study. Three interviews were held separately with social workers working in Vulindlela using semi – structured questionnaires to collect data. Thematic analysis was used to develop themes that emerged from the data collected. Key findings of the study revealed that social workers were heavily integrated in the communities in which they work and therefore have increased community exposure to play an important communicative role in the introduction and uptake of oral PrEP. The study overall found that HIV interventions does not need to be largely concentrated with nurses and primary health care facilities but can be extended to social development interventions in communities as well.