Structural barriers and facilitators to accessing HIV services for marginalized working populations: insights from farm workers in South Africa

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dc.contributor.authorLembani, Martina
dc.contributor.authorMlangeni, Nosimilo
dc.contributor.authorAdetokunboh, Olatunji
dc.date.accessioned2025-06-17T09:48:38Z
dc.date.available2025-06-17T09:48:38Z
dc.date.issued2025
dc.description.abstractFarm workers are vulnerable working populations who face significant inequalities in accessing health services, including those for human immunodeficiency virus (HIV) prevention, treatment and care. This descriptive phenomenological study aimed to explore farm workers’ experiences when accessing HIV services and was conducted in Limpopo province, South Africa. Eighteen in-depth interviews were conducted in four health facilities from two districts, and two focus group discussions were conducted in one of the farms within the province. Purposive sampling and systematic random sampling were used to select study participants. A deductive thematic approach was used to analyse data, informed by the social–ecological model of health. The results reveal that farm workers perceive multiple interdependent factors that inhibit or enable their access to HIV healthcare services. Key barriers to HIV healthcare were transport affordability, health worker attitudes, stigma and discrimination, models of HIV healthcare delivery, geographic location of health facilities and difficult working conditions. Key facilitators to HIV healthcare included the availability of mobile health services, the presence of community health workers and a supportive work environment. The findings suggest disparities in farm workers’ access to HIV services, with work being the main determinant of access. We, therefore, recommend a review of HIV policies and programmes for the agricultural sector and models of HIV healthcare delivery that address the unique needs of farm workers.
dc.identifier.citationMlangeni, N., Lembani, M., Adetokunboh, O. and Nyasulu, P.S., 2025. Structural barriers and facilitators to accessing HIV services for marginalized working populations: insights from farm workers in South Africa. Health Policy and Planning, 40(1), pp.75-84.
dc.identifier.urihttps://doi.org/10.1093/rasti/rzaf001
dc.identifier.urihttps://hdl.handle.net/10566/20512
dc.language.isoen
dc.publisherOxford University Press
dc.subjectAccess to health services
dc.subjectFarm workers
dc.subjectHIV
dc.subjectSocial determinants of health
dc.subjectUniversal health coverage
dc.titleStructural barriers and facilitators to accessing HIV services for marginalized working populations: insights from farm workers in South Africa
dc.typeArticle

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