On an evening in 2016, the usually earnest atmosphere of an academic meeting and lecture venue was transformed by the sound of chatter, laughter, and exclamation, as people examined sketches of bones displayed on pin boards and observed, with varying degrees of interest, a group of students demonstrating a version of surya namaskar, the sun salutation, practised in yoga. On a table, copies of booklets containing poems and stories held the attention of those who stopped to read them. As the crowd made their way down to the lecture theatre to listen to music, singing, poetry, and spoken word pieces, they passed an exhibition of photos. Some participants cast a quick eye over the images, others stopped and looked, and read the captions underneath. The creators of these images engaged in conversations with the viewers-some of which were serious and some light-hearted. A similar scene-one that disrupted the usual use of space and place-had occurred in 2015 in another venue where other images addressing the experiences of being medical students in the Faculty of Health Sciences at the University of Cape Town (UCT), in South Africa, were exhibited (Figures 1 & 2). The writing, drawings, yoga, music, and photographs were all part of evenings showcasing month-long special study modules facilitated by the Primary Health Care Directorate and undertaken by second year medical students registered for the Bachelor of Medicine, Bachelor of Surgery (MBChB) degree. These special study modules were linked either to the field of Medical and Health Humanities (MHH)
Background
Understanding and addressing healthcare and service delivery inequalities is essential to increase equity and overcome health disparities and service access discrimination. While tremendous progress has been made towards the inclusion of sexual and gender minorities in health and other research, gaps still exist. Innovative methods are needed to close these. This case study describes and reflects on using online-based data collection to ascertain sexual health decision-making and health service utilisation among Kenyan queer womxn and trans men.
Methods
Case study
The study used a mixed-methods approach in two phases with triangulated quantitative and qualitative elements. Both elements used web-based technology to gather data.
Results
Using online spaces to recruit and collect data from queer womxn and trans men exceeded expectations. A total of 360 queer womxn and trans men responded to the digitally distributed survey, and 33 people, queer womxn and trans men, as well as key informants, participated in the interviews, which were primarily conducted on Zoom and Skype. The case study analyses the risks and benefits of this approach and concludes that online sampling approaches can mitigate risks and enable effective and safe sampling of a marginalised group in a restrictive legal setting: Kenyan queer womxn and trans men.
Conclusion
Using online spaces when researching marginalised populations could effectively overcome risks around stigma, discrimination and violence. It could be an effective way to understand these populations’ healthcare needs better. Factors contributing to success included building trusting relationships with key members of the community, strategic and opportune timing, a nuanced understanding of the mobile landscape, and carefully chosen safety and security measures. However, it should be noted that conducting research online could increase the risk of further marginalising and excluding those without access to web-based technology.
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