Taking empowerment into account: the response of community-based organisations to the HIV care needs of men who have sex with men in West Africa (CohMSM ANRS 12324 – Expertise France)

ABSTRACT

Empowerment is an ongoing process through which individuals and communities appropriate power and acquire the capability to function autonomously. Research on empowerment in men who have sex with men (MSM) is lacking in community-based contexts. We investigated the relationship between willingness to be empowered and HIV care needs in West African MSM accessing community-based organisations’ (CBO) services. Fifty-three interviews were administered to HIV-negative MSM participating in the CohMSM study (Mali, Burkina Faso, Côte d’Ivoire, Togo). Five indicators of empowerment were identified from a discourse analysis: (i) motivation to access HIV services, (ii) willingness to improve HIV services, (iii) desire to be involved in new activities, (iv) desire to participate in such services, (v) willingness to collaborate in decision making. Based on these indicators, participants were classified into two profiles: high (19/53, 36%) and low (34/53, 64%) level of willingness to be empowered (HWE, LWE). Using a thematic analysis, HWE participants were focused on collective benefit (preventive follow-up, questions about MSM identity), while LWE participants were centred on individual benefit (medical care). CBOs should consider empowerment as a tool to advance collective health benefits for MSM. To improve empowerment in MSM, specific training on issues regarding sexual identity and stigma is needed for CBO providers.

KEYWORDS:

• MSM
• HIV
• empowerment
• community-based organisations
• Africa

Acknowledgements

We sincerely thank the MSM participants and the staff of the community-based organisations (ARCAD-SIDA, Espace Confiance, Association African Solidarité, Espoir Vie Togo) who participated in the CohMSM study. Our thanks also to Jude Sweeney for the English revision. The CohMSM Study Group: Clotilde COUDERC, Bruno GRANOUILLAC, Suzanne IZARD, Christian LAURENT, Laura MARCH, Martine PEETERS, Laetitia SERRANO (IRD UMI 233, INSERM U 1175, Université de Montpellier, unité TransVIHMI, Montpellier, France); Cyril BERENGER, Michel BOURRELLY, Pierre-Julien COULAUD, Gwenaëlle MARADAN, Bakri M’MADI MRENDA, Marion MORA, Enzo PARISI, Luis SAGAON-TEYSSIER, Bruno SPIRE (UMR 912, INSERM, IRD, Université Aix-Marseille, Unité SESSTIM, Marseille, France); Adeline BERNIER, Paméla PALVADEAU, Daniela ROJAS CASTRO, Emmanuel TRENADO (Coalition Internationale Sida, Pantin, France); Drissa CAMARA, Oumar CISSE, Alou COULIBALY, Bintou DEMBELE KEITA, Fodié DIALLO, Mahamadou DIARRA, Mady GADJIGO, Abdoul Aziz KEITA, Kader MAIGA, Aly OUOLOGUEM, Fodé TRAORE (ARCAD-SIDA, Bamako, Mali); Niamkey Thomas AKA, Camille ANOMA, Stéphane-Alain BABO YORO, Noufo Hamed COULIBALY, Rachelle KOTCHI, Patrick KOUABENAN, Malan Jean-Baptiste KOUAME, Kpassou Julien LOKROU, Frédéric Dibi N’GUESSAN (Espace Confiance, Abidjan, Côte d’Ivoire); Xavier ANGLARET, Jean-Marie MASUMBUKO, Maxime OGA (PACCI, Abidjan, Côte d’Ivoire); Christian COULIBALY, Ter Tiero Elias DAH, Ousseni ILBOUDO, Joseph OUEDRAOGO, Mamadou OUEDRAOGO, Elisabeth THIO, Juste Rodrigue TOURE, Abdoulazziz TRAORE, Issa TRAORE (Association African Solidarité, Ouagadougou, Burkina Faso); Fiffou YOUGBARE (Centre National de Transfusion Sanguine, Ouagadougou, Burkina Faso); Nicolas MEDA (Centre de Recherche Internationale pour la Santé, Ouagadougou, Burkina Faso); Kouakou Kokouvi Selom AGBOMADJI, Richard Mawuényégan Kouamivi AGBOYIBOR, Messan ATTIOGBE, Aléda Mawuli BADJASSIM, Agbégnigan Lorette EKON, Anouwarsadat KOKOUBA, Ephrem MENSAH, Diimiln Joseph Strauss TABLISSI, Kossi Jeff YAKA (Espoir Vie Togo, Lomé, Togo); Claver Anoumou Yaotsè DAGNRA (Laboratoire BIOLIM, Université de Lomé, Lomé, Togo).

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by the ANRS (France Recherche Nord & Sud Sida-hiv Hépatites; ANRS 12324) and Expertise France (Initiative 5%). PJC was the recipient of a doctoral fellowship from ANRS (B7-ANRS 12324) and Sidaction (17-2-FJC-11561).