Experiences and challenges in sexual health service access among men who have sex with men in Kenya

ABSTRACT

Men who have sex with men (MSM) in Kenya bear a heavy burden of HIV/STIs and are a priority population in the national HIV/AIDS response, yet remain criminalised and stigmatised within society. HIV pre-exposure prophylaxis (PrEP) offers an opportunity to significantly impact the HIV epidemic, as does the concept of U = U, whereby those who are living with HIV and on treatment are uninfectious when their viral load has been suppressed so as to be undetectable. However, the value of such innovations will not be realised without sufficient understanding of, and respect for, the sexual health service provision needs of MSM. This paper describes findings from 30 in-depth interviews with MSM living in Nairobi that explored engagement with sexual health service providers, barriers to access and perceived opportunities to improve service design and delivery. Findings indicate concern relating to the professionalism of some staff working within public hospitals as well as feelings that many sexual health services were not considered safe spaces for the discussion of MSM-specific sexual behaviour. Diverse views were expressed relating to comfort in public, community and private sexual health services as well as how these are and should be organised.

KEYWORDS:

• MSM
• Kenya
• sexual health services
• stigma
• discrimination

Acknowledgements

We thank and acknowledge the participants of the TRANSFORM study as well as other members of the team involved in complimentary phases of work aimed at establishing HIV and STI prevalence among MSM in Nairobi and colleagues based at the partner TRANSFORM site in Johannesburg, South Africa. We are also grateful to our community-based partners, GALCK, HOYMAS and ISHTAR for their valuable contributions to study design and interpretation of data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by Evidence for HIV Prevention in Southern Africa (EHPSA), a UK Aid programme managed by Mott MacDonald (reference MM/EHPSA/WHC/0116029).DFID