Division of Social and Behavioural Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Glob Public Health. 2022 Feb;17(2):223-234. doi: 10.1080/17441692.2021.1872680. Epub 2021 Jan 20.
South Africa is burdened by twin epidemics of HIV and tuberculosis (TB) in which men are less likely than their female counterparts to engage with prevention, treatment and care. In some Cape Flats communities in Cape Town, South Africa, the challenge to men is compounded by high levels of gang violence. This study investigates the role of gang violence as a barrier to men's entry and retention in the HIV/TB care cascade. Data for this study drew from six weeks of participant observation and eleven in-depth interviews in Hanover Park, a largely Coloured township of Cape Town. Key findings concerned men's restricted mobility due to gang violence as a result of conflict over gang territory. Men both inside and outside gangs are affected by this violence, with men in gangs, in most cases, being totally cut off from healthcare services. Men in gangs are a key risk population group for both HIV and TB programming. Community-based interventions that address the effects of violence on health services should be designed for the communities on the Cape Flats. Findings could potentially be extrapolated to other settings affected by gang violence, both within South Africa and abroad.
南非深受艾滋病病毒和结核病（TB）双重流行的困扰，男性参与预防、治疗和护理的可能性低于女性。在南非开普敦的一些开普弗拉特社区，帮派暴力使男性面临的挑战更加复杂。本研究调查了帮派暴力作为男性进入和留在艾滋病病毒/结核病护理级联的障碍的作用。本研究的数据来自于在开普敦的一个主要有色人种镇汉诺威公园进行的六周的参与观察和十一次深入访谈。主要发现涉及由于帮派领地冲突导致的帮派暴力对男性行动能力的限制。无论是在帮派内部还是外部的男性都受到这种暴力的影响，在大多数情况下，帮派成员完全被切断了与医疗服务的联系。帮派成员是艾滋病毒和结核病规划的一个关键高危人群。应该为开普弗拉特社区设计针对暴力对卫生服务影响的基于社区的干预措施。研究结果可能会推广到南非国内外其他受帮派暴力影响的地区。
