Health services we can trust: how same-sex attracted men in Dar Es Salaam, Tanzania would like their HIV healthcare to be organised

Abstract

Drawing on qualitative research in Dar es Salaam, Tanzania, this article explores how men who engage in sex with other men perceive their interactions with healthcare providers, and how they would prefer healthcare services to be organised and delivered. The paper describes the strengths and weaknesses men associate with private and public healthcare; the advantages and disadvantages they associate with dedicated clinics for sexual minority persons; what they conceive of as good healthcare services; and how they would characterise a good healthcare worker. The paper also presents recommendations made by study participants. These include the view that health services for same-sex attracted men should be developed and delivered in collaboration with such men themselves; that health workers should receive training on the medical needs as well as the overall circumstances of same-sex attracted men; and that there should be mechanisms that make healthcare available to poorer community members. We analyse men’s views and recommendations in the light of theoretical work on trust and discuss the ways in which same sex attracted men look for signs that healthcare workers and healthcare services are trustworthy.

Keywords:

• Same sex attracted men
• healthcare services
• Tanzania

Acknowledgements

We thank participants for contributing to this study.

Disclosure statement

The authors declare that they have no competing interests.

Notes

1 Community entry permits meant that after getting ethical clearance from MUHAS Institutional Review Board, we had also to get permission from the President’s Office responsible for Regional Administration and Local Government as well as from the Dar-es-Salaam Regional Authorities before conducting the study among same-sex attracted men.

2 Mashoga [singular: shoga] refers to a Swahili term used to refer to same-sex attracted men.

3 Wasenge [singular: msenge] is another Swahili term used to refer to same-sex attracted men in Dar es Salaam.

Additional information

Funding

The research described in this paper received funding from the Danish Fellowship Centre-DANIDA through project number 16-P03-TAN as part of the Access to Healthcare Services among Key Populations in Tanzania project.