"If You Tell People That You Had Sex with a Fellow Man, It Is Hard to Be Helped and Treated": Barriers and Opportunities for Increasing Access to HIV Services among Men Who Have Sex with Men in Uganda

PloS One
Rhoda WanyenzeGlenn Wagner

Abstract

Despite the high HIV prevalence among men who have sex with men (MSM) in sub-Saharan Africa, little is known about their access to HIV services. This study assessed barriers and opportunities for expanding access to HIV services among MSM in Uganda. In October-December 2013, a cross-sectional qualitative study was conducted in 12 districts of Uganda. Semi-structured in-depth interviews were conducted with 85 self-identified MSM by snowball sampling and 61 key informants including HIV service providers and policy makers. Data were analysed using manifest content analysis and Atlas.ti software. Three quarters of the MSM (n = 62, 72.9%) were not comfortable disclosing their sexual orientation to providers and 69 (81.1%) felt providers did not respect MSM. Half (n = 44, 51.8%) experienced difficulties in accessing health services. Nine major barriers to access were identified, including: (i) unwelcoming provider behaviours; (ii) limited provider skills and knowledge; (iii) negative community perceptions towards MSM; (iv) fear of being exposed as MSM; (v) limited access to MSM-specific services; (vi) high mobility of MSM, (vii) lack of guidelines on MSM health services; viii) a harsh legal environment; and ix) HIV related stigma. Tw...Continue Reading

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Citations

Aug 25, 2016·Journal of Empirical Research on Human Research Ethics : JERHRE·Carlton Lawrence, Kearsley Stewart
Jan 31, 2018·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Hannah BrooksChristina J Jones
Jul 3, 2018·Cognitive Research: Principles and Implications·Stephen H AdamoStephen R Mitroff
Dec 5, 2019·International Journal of STD & AIDS·Colin RussellSteven Y Hong
Dec 9, 2016·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Tonderai MabutoChristopher J Hoffmann
Jan 1, 2016·International Journal of Sexual Health : Official Journal of the World Association for Sexual Health·Markus LarssonAnette Agardh
Sep 19, 2017·Current Opinion in Pediatrics·Elizabeth A SilberholzAmy E Pattishall
May 19, 2019·BMC Health Services Research·Lester KapandaAdamson S Muula
Jan 17, 2021·Patient Education and Counseling·Sarah A GioiaJoshua G Rosenberger
May 20, 2021·Health SA = SA Gesondheid·Idah MoyoAzwihangwisi H Mavhandu-Mudzusi
Jun 12, 2021·The Journal of the Association of Nurses in AIDS Care : JANAC·Valerie YelvertonGary W Harper

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