1 University of Toronto, Toronto, Ontario, Canada.
2 Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.
Health Educ Behav. 2019 Feb;46(1):146-156. doi: 10.1177/1090198118760682. Epub 2018 Mar 28.
Stigma and discrimination affecting lesbian, gay, bisexual, and transgender (LGBT) people compromise health and human rights and exacerbate the HIV epidemic. Scant research has explored effective LGBT stigma reduction strategies in low- and middle-income countries. We developed and pilot-tested a participatory theatre intervention (PTI) to reduce LGBT stigma in Swaziland and Lesotho, countries with the world's highest HIV prevalence. We collected preliminary data from in-depth interviews with LGBT people in Lesotho and Swaziland to enhance understanding of LGBT stigma. Local LGBT and theatre groups worked with these data to create a 2-hour PTI composed of three skits on LGBT stigma in health care, family, and community settings in Swaziland (Manzini) and Lesotho (Maseru, Mapoteng). Participants ( n = 106; nursing students, health care providers, educators, community members) completed 12 focus groups following the PTI. We conducted thematic analysis to understand reactions to the PTI. Focus groups revealed the PTI increased understanding of LGBT persons and issues, increased empathy, and fostered self-reflection of personal biases. Increased understanding included enhanced awareness of the negative impacts of LGBT stigma, and of LGBT people's lived experiences and issues. Participants discussed changes in attitude and perspective through self-reflection and learning. The format of the theatre performance was described as conducive to learning and preferred over more conventional educational methods. Findings indicate changed attitudes and awareness toward LGBT persons and issues following a PTI in Swaziland and Lesotho. Stigma reduction interventions may help mitigate barriers to HIV prevention, treatment, and care in these settings with a high burden of HIV.
污名和歧视影响到女同性恋、男同性恋、双性恋和跨性别者（LGBT）人群的健康和人权，并使艾滋病疫情恶化。在中低收入国家，几乎没有研究探索有效的减少 LGBT 污名的策略。我们开发并试点了一种参与式戏剧干预（PTI），以减少斯威士兰和莱索托的 LGBT 污名，这两个国家是世界上艾滋病感染率最高的国家。我们从莱索托和斯威士兰的 LGBT 人群的深入访谈中收集了初步数据，以增强对 LGBT 污名的理解。当地的 LGBT 和戏剧团体利用这些数据在斯威士兰（曼齐尼）和莱索托（马塞卢、马波滕）的医疗保健、家庭和社区环境中创作了三个关于 LGBT 污名的短剧，组成了一个 2 小时的 PTI。参与者（n=106；护理学生、医疗保健提供者、教育工作者、社区成员）在 PTI 后完成了 12 个焦点小组。我们进行了主题分析，以了解对 PTI 的反应。焦点小组显示，PTI 增加了对 LGBT 人群和问题的理解，增加了同理心，并促进了对个人偏见的自我反思。增加的理解包括提高对 LGBT 污名的负面影响以及 LGBT 人群的生活经历和问题的认识。参与者通过自我反思和学习讨论了态度和观点的变化。戏剧表演的形式被描述为有利于学习，并且比更传统的教育方法更受欢迎。研究结果表明，在斯威士兰和莱索托进行 PTI 后，对 LGBT 人群和问题的态度和意识发生了变化。减少污名的干预措施可能有助于缓解这些艾滋病负担沉重的环境中预防、治疗和护理艾滋病的障碍。
