Ubrihien Ashley, Lewis David A, Rambaldini Boe, Kirwan Morwenna, Gwynne Kylie
Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Macquarie University, Sydney, NSW, Australia.
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia.
Int J STD AIDS. 2023 Oct;34(11):803-808. doi: 10.1177/09564624231179766. Epub 2023 Jun 5.
Incidence of sexually transmissible infections (STI) amongst young Aboriginal people in Australia are significantly higher compared to the wider population. Low levels of engagement with public sexual health services also exacerbates health inequity. This study sought to understand the access barriers facing Aboriginal People with local Sexual Health services from the perspective of local clinicians within Western Sydney.
Six clinicians (six registered nurses, two medical practitioners) and two social workers, working in a Sexual Health service, were interviewed using a semi-structure questionnaire. Interviews were audio recorded and transcribed verbatim. Interview texts were analysed using NVIVO 12 and a thematic analysis undertaken.
Thematic analysis revealed three broad themes: personal, practical, and programmatic. Clinicians believed the involvement of Aboriginal people in service delivery would contribute to greater inclusion and more culturally competent services. Clinicians also considered that young Aboriginal people were unaware of the risks of untreated STIs, and that greater STI-related education regarding risk and prevention may reduce STI incidence and improve participation in services. Clinicians believed that culturally-competent STI education would be more effective if co-designed with the local Aboriginal community. Clinicians identified that Aboriginal young people were concerned about their privacy when accessing services, and that barriers could be reduced by greater community engagement in service delivery design and quality improvement initiatives.
The three themes identified in this study provide guidance for service providers about approaches that may enhance the access, participation, and cultural safety sexual health services for Aboriginal clients.
与更广泛的人群相比，澳大利亚年轻原住民中性传播感染（STI）的发病率显著更高。对公共性健康服务的参与度较低也加剧了健康不平等。本研究旨在从悉尼西部当地临床医生的角度了解原住民在获取当地性健康服务时面临的障碍。
对在一家性健康服务机构工作的六名临床医生（六名注册护士、两名医生）和两名社会工作者进行了半结构化问卷调查访谈。访谈进行了录音并逐字转录。使用NVIVO 12对访谈文本进行分析并进行了主题分析。
主题分析揭示了三个广泛的主题：个人、实际和规划。临床医生认为原住民参与服务提供将有助于实现更大程度的包容和提供更具文化能力的服务。临床医生还认为年轻原住民没有意识到未经治疗的性传播感染的风险，更多关于风险和预防的性传播感染相关教育可能会降低性传播感染的发病率并提高对服务的参与度。临床医生认为，如果与当地原住民社区共同设计，具有文化能力的性传播感染教育会更有效。临床医生发现原住民年轻人在获取服务时担心隐私问题，通过让社区更多地参与服务提供设计和质量改进举措可以减少障碍。
本研究确定的三个主题为服务提供者提供了指导，说明哪些方法可能会增强原住民客户获得性健康服务的机会、参与度以及文化安全性。
