Narratives of young black men on barriers to health care and poor health care seeking behaviours at a university setting: a qualitative study.

BACKGROUND: Institutions of higher learning provide education, training, independence and life-long skills for young people. However, for students to achieve their optimal growth and intellectual development they need to be healthy psychologically, mentally and physically. This can be achieved through the development of effective health programs for all university students. This qualitative study was designed to explore Black male students' perspectives and experiences regarding the utilization of on-campus health services at the University of KwaZulu-Natal. METHODS: The study population was selected using purposive sampling. Data were collected using four focus group discussions (FGDs) with 36 participants and three key informant interviews. Thematic analysis was conducted to identify the key patterns and themes that emerged from the data. RESULTS: Emerging themes included poor knowledge and awareness, negative perceptions and attitudes, fear and lack of privacy, and negative experiences leading to poor access and utilization of campus health services. The findings suggested a need for more advocacy and awareness campaigns especially among first year students, campaigns for normalization of sexual health, addressing HIV stigma and discrimination, providing youth friendly services to improve students' use of sexual health services, and ultimately, their overall health and well-being. CONCLUSIONS: The findings give valuable insights from male students on the barriers and potential solutions to campus health services and highlight where improvements can be directed to increase access and use of health services by the study population.

Intersectionality of cultural norms and sexual behaviours: a qualitative study of young Black male students at a university in KwaZulu-Natal, South Africa.

BACKGROUND: Sexual risk behaviours that occur among young men are based on dominant notions and practices that prevail in cultural contexts. As such, understanding the intersection of cultural norms and sexual risk behaviours among young men is very important. METHODS: The study used a qualitative design and conducted four focus group discussions with 36 male students who were purposively selected from different levels of study at the University of KwaZulu-Natal. Data were analysed through line-by-line coding, and grouped into emerging themes and sub-themes facilitated by the use of Atlas.ti. RESULT: The findings emphasize that socialisation agents such as the family, peers and community play an important role in prescribing acceptable and unacceptable sexual behaviour of young men. Some of the young men seemed to adhere to prescribed gender norms of what it means to be a man while some rejected them for alternative versions of being a man. In the context of the university environment, these findings reveal that male students cannot make informed decisions regarding condom use when they are intoxicated, and thus expose themselves to sexually transmitted infections and other risks. CONCLUSION: University sexual risk reduction programs should be developed considering the specific cultural context, using strategies that empower young men to challenge the widely accepted cultural norms that may predispose them to sexual risks. Sexual behaviours and cultural norms are interconnected, it is through culture that people learn how to behave and understand the world around them. In many cultural contexts, young men are taught from a very young age how to behave based on dominant notions of what it means to be a man in that particular context. As such, in some cultural context sexual risk-taking such as having multiple sexual partners and unprotected sex are perceived as normal behaviour for men. Some young men embrace such normalised sexual behaviours which often has negative implications on their future. This study explored the influence of cultural norms on the sexual behaviour of young men. This qualitative study was conducted at the University of KwaZulu-Natal. Four focus group discussions were conducted among first-year students to postgraduate students who were between the ages of 18 to 30 years. Our findings revealed that there other influences on the sexual behaviours of the young men, which included family, community and peers. It also emerged that gender norms regarding what it means to be a man still prevailed which some of the young men in the study adhered to, notably such notions seemed to be rejected by some of them. The university setting appeared to be space where a lot of sexual risk-taking took place, which potentially exposed the young men in the study to many sexual risks. In conclusion, targeted programs for the university setting should aim to challenge gender norms that expose young men to sexual risks.