Background: Literature suggests that Lesbian, Gay, Bisexual, Transgender, Intersex, Queer and Allied (LGBTQIA+) individuals encounter challenges with access and engagement with health services. Studies have reported that LGBTQIA+ individuals' experiences stigma, discrimination and health workers' micro aggression when accessing healthcare. There is compelling evidence to suggest that the LGBTQIA+ community are faced with disproportionate rates of HIV infection, mental health disorders, substance abuse and other non-communicable diseases. The South African National Strategic Plan (NSP) on HIV/AIDS, TB and STI's (2023-2028) recognises the need for providing affirming LGBTQIA+ health care as part of the country's HIV/AIDS response strategy that is rooted in comprehensive and holistic care underpinned by the principles of community oriented primary healthcare. However, current anecdotal evidence suggests paucity of LGBTQIA+ and key populations health content in the undergraduate health science curricula in South Africa. Moreover, literature reveals a general lack of health worker training regarding the health needs of LGBTQIA+ persons and other key populations such as sex workers, People Who Inject Drugs (PWID) and Men who have Sex with Men (MSM).
Objective: This protocol paper describes the design of a project that aims at facilitating the inclusion of health content related to the LGBTQIA+ community and other key populations in the undergraduate nursing curricula of KwaZulu-Natal, South Africa.
Methods: A multi-methods design encompassing collection of primary and secondary data using multiple qualitative designs and quantitative approaches will be used to generate evidence that will inform the co-design, testing and scale-up of strategies to facilitate the inclusion of LGBTQIA+ and key populations content in undergraduate nursing curricula in KwaZulu-Natal, South Africa. Data will be collected using a combination of convenience, purposive and snow ball sampling techniques from LGBTQIA+ persons, academic staff, undergraduate nursing students and other key populations such as MSM, PWID and sex workers. Primary data will be collected through individual in-depth interviews, focus groups discussions and surveys guided by semi-structure and structured data collection tools. Data collection and analysis will be an iterative process guided by the respective research design to be adopted. The continuous quality improvement process to be adopted during data gathering and analysis will ensure contextual relevance and sustainability of the resultant co-designed strategies that are to be scaled-up as part of the overarching objective of this study.
Results: The proposed study is designed in response to recent contextual empirical evidence highlighting the multiplicity of health challenges experienced by LGBTQIA+ individuals and key populations in relation to health service delivery and access to healthcare. The potential findings of the study may be appropriate for contributing to the education of nurses as one of the means to ameliorate these problems.
Conclusions: This research has potential implications for nursing education in South Africa and worldwide as it addresses up-to-date problems in the nursing discipline as it pertains to undergraduate students' preparedness for addressing the unique needs and challenges of the LGBTQIA+ community and other key populations. The findings may also provide baseline data to inform knowledge transfer to other health sciences disciplines that have not included LGBTQIA+ content in their undergraduate curricula in South Africa.