By Alex, February 11th, 2016 in
Sexual Health and Reproductive Health week is observed each year from 8th to 12th February.This year’s theme “What is your relationship status?” focuses on the connection between service users and service providers.
The theme calls for a reflection on one of the core conditions for providing effective care: Relationship. Carl Rogers, a Psychotherapist theorist, has emphasized that for therapists/providers to improve their clients’ health conditions they must be warm, genuine and understanding. These are key ingredients for building effective relationship with clients. Unfortunately, there are situations where service providers fail to build genuine relationships and thus leave clients/service users feeling “horrible”. It is within this context that I find the theme very appropriate.
Members of the Black communities experience racism often subtly but sometimes overtly. They experience “layered stigma and discrimination” (Stigma Project, 2007) if, as Blacks they are also ‘immigrants’/’refugees’, ‘undocumented’, ‘muslims’ and or ‘HIV positive’. Sadly, there have been instances when Blacks who are HIV positive (BPHAs) have had to bear experiences of racism, stigma and discrimination even from those who have trained to provide care and support for vulnerable members of the society. One BPHA recounted how at a clinic a Doctor called out her name, ‘announced’ that she was HIV+ and advised her to seek services elsewhere because the clinic did not take care of HIV patients. Another BPHA had confided in her Pastor that she was HIV+ only to be advised that she would have to inform the entire congregation during a church service. Stories like these are the reasons why some BPHAs do not seek services or do so grudgingly.
Having an effective relationship with clients also means respecting confidentiality – that popular concept all service providers know but which they sometimes inadvertently betray. BPHAs are particularly concerned about their service providers breaking confidentiality. Questions about whom the provider is, and where they come from are important to them. Some are wary about meeting with service providers who are also from the Black community fearing that if they happen to have common friends, relatives or community members, information about their HIV status could filter out.
The Stigma Project (2007) analyzed documents, policies and practices of 85 organizations and health centers serving underprivileged and HIV+ clients and found that their policies were fair, ethical and promoted non-discriminatory care. If (as this study seems to indicate) organizational policies are generally fair, then why do some PHAs from Black communities still report experiences of stigma and discrimination? The answer to this question is what this year’s theme is drawing attention to. Service Providers play a critical role in shaping health outcomes resulting from the sessions they have with their service users. Therefore, it is important that they build and sustain healthy relationships with their clients that will not only facilitate in-session conversations but also increase their self-worth, and contribute to the empowerment they need to manage or overcome their health conditions.
For PHA’s from the Black communities who experience stigma and discrimination from their service providers, the theme guiding the observance of this year’s Sexual Health and Reproductive Health Week couldn’t have come at a better time. Service Providers have the opportunity once again to reflect on how they relate with their BPHA clients.
Some useful links for service providers:
The Stigma Project: http://www.caan.ca/wp-content/uploads/2012/05/The-Influence-of-Stigma-on-Access-to-Health-Services-by-Persons-with-HIV-Illness.pdf (accessed February 10 2016)