‘Fighting an uphill battle’: a qualitative study of the challenges encountered by pharmacy workers when providing services to men who have sex with men in Dar es Salaam, Tanzania

References

• Beyrer C, Baral SD, van Griensven F, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380:367–10.
   PubMed Web of Science ®Google Scholar
• Joint United Nations Programme on HIV and AIDS. The gap report. Geneva: Joint United Nations Programme on HIV/AIDS; 2014. ISBN 978-92-9253-062-4.
   Google Scholar
• Joint United Nations Programme on HIV and AIDS. On the Fast-Track to end AIDS. UNAIDS 2016–2021 strategy. Geneva: Joint United Nations Programme on HIV/AIDS; 2015.
   Google Scholar
• Leshabari MT, Mmbaga EJ, Mpembeni R, et al. Prevalence of the Human Immunodeficiency Virus, other sexually transmitted infections, and health-related perceptions, reflections, experiences and practices among men having sex with men in Dar es Salaam. Dar es Salaam: Tanzania Commission for AIDS; 2013. p. 1–49.
   Google Scholar
• Mmbaga EJ, Moen K, Makyao N, et al. HIV and STI s among men who have sex with men in Dodoma municipality, Tanzania: a cross-sectional study. Sex Transm Infect. 2017;93:314–319. Epub 2017/ 02/17. PubMed PMID: 28202736.
   Web of Science ®Google Scholar
• Ross MW, Nyoni J, Ahaneku HO, et al. High HIV seroprevalence, rectal STIs and risky sexual behaviour in men who have sex with men in Dar es Salaam and Tanga, Tanzania. BMJ Open. 2014;4:e006175. Epub 2014/08/30. PubMed PMID: 25168042; PubMed Central PMCID: PMCPMC4156794.
   PubMed Web of Science ®Google Scholar
• Dahoma M, Johnston LG, Holman A, et al. HIV and related risk behavior among men who have sex with men in Zanzibar, Tanzania: results of a behavioral surveillance survey. AIDS Behav. 2011;15:186–192. Epub 2009/ 12/10. PubMed PMID: 19997862.
   PubMed Web of Science ®Google Scholar
• King R, Barker J, Nakayiwa S, et al. Men at risk; a qualitative study on HIV risk, gender identity and violence among men who have sex with men who report high risk behavior in Kampala, Uganda. PloS One. 2013;8:e82937. Epub 2013/12/21. PubMed PMID: 24358239; PubMed Central PMCID: PMCPMC3866199.
   PubMed Web of Science ®Google Scholar
• Smith AD, Muhaari AD, Agwanda C, et al. Heterosexual behaviours among men who sell sex to men in coastal Kenya. AIDS. 2015;29 Suppl 3:S201–10. Epub 2015/ 11/14. PubMed PMID: 26565965; PubMed Central PMCID: PMCPMC4706370.
   Web of Science ®Google Scholar
• Smith AD, Tapsoba P, Peshu N, et al. Men who have sex with men and HIV/AIDS in sub-Saharan Africa. Lancet. 2009;374:416–422.
   PubMed Web of Science ®Google Scholar
• International Lesbian Gay Bisexual Trans and Intersex Association; Carroll A, Mendos LR. State sponsored Homophobia 2017: a world survey of sexual orientation laws: criminalisation, protection and recognition. Geneva: International Lesbian Gay Bisexual Trans and Intersex Association; 2017.
   Google Scholar
• Government of Tanzania. The sexual offences special provisions Act, 1998 § 154. Dar es Salaam: Government of Tanzania; 1998.
   Google Scholar
• Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27:363–385.
   Web of Science ®Google Scholar
• Dudley JR. Confronting stigma within the services system. Soc Work. 2000;45:449–455. Epub 2000/10/13. PubMed PMID: 11029900.
   PubMed Web of Science ®Google Scholar
• Scambler G. Stigma and disease: changing paradigms. Lancet. 1998;352:1054–1055.
   PubMed Web of Science ®Google Scholar
• Herek G. Beyond Homophobia: thinking about sexual stigma and prejudice in the twenty-first century. Sexuality Res Soc Policy. 2004;1:6–24.
   Google Scholar
• Niang CI, Tapsoba P, Weiss E, et al. ‘It’s raining stones’: stigma, violence and HIV vulnerability among men who have sex with men in Dakar, Senegal. Cult Health Sex. 2003;5:499–512.
   Web of Science ®Google Scholar
• Fay H, Baral SD, Trapence G, et al. Stigma, health care access, and HIV knowledge among men who have sex with men in Malawi, Namibia, and Botswana. AIDS Behav. 2011;15:1088–1097.
   PubMed Web of Science ®Google Scholar
• Risher K, Adams D, Sithole B, et al. Sexual stigma and discrimination as barriers to seeking appropriate healthcare among men who have sex with men in Swaziland. J Int AIDS Soc. 2013;16:18715. PubMed PMID: 24242263.
   PubMed Web of Science ®Google Scholar
• Magesa DJ, Mtui LJ, Abdul M, et al. Barriers to men who have sex with men attending HIV related health services in Dar es Salaam, Tanzania. Tanzan J Health Res. 2014;16:118–126. Epub 2014/04/01. PubMed PMID: 26875306.
   PubMedGoogle Scholar
• Ross MW, Larsson M, Nyoni JE, et al. Prevalence of STI symptoms and high levels of stigma in STI healthcare among men who have sex with men in Dar es Salaam, Tanzania: a respondent-driven sampling study. Int J STD AIDS. 2017;28:925–928. Epub 2016/ 12/04. PubMed PMID: 27913795.
   PubMed Web of Science ®Google Scholar
• Larsson M, Ross MW, Mansson SA, et al. Being forced to become your own Doctor - men who have sex with men’s experiences of stigma in the Tanzanian Healthcare System. Int j sexual health. 2016;28:163–175. Epub 2016/ 01/01. PubMed PMID: 28491204; PubMed Central PMCID: PMCPMC5421638.
   PubMed Web of Science ®Google Scholar
• Felicity S. Private local pharmacies in low‐ and middle‐income countries: a review of interventions to enhance their role in public health. Trop Med Int Health. 2009;14:362–372.
   Web of Science ®Google Scholar
• Goodman C, Kachur SP, Abdulla S, et al. Drug shop regulation and malaria treatment in Tanzania–why do shops break the rules, and does it matter? Health Policy Plan. 2007;22:393–403. Epub 2007/ 10/09. PubMed PMID: 17921151; PubMed Central PMCID: PMCPMC2657823.
   PubMed Web of Science ®Google Scholar
• Kagashe GA, Minzi O, Matowe L. An assessment of dispensing practices in private pharmacies in Dar-es-Salaam, Tanzania. Int J Pharm Pract. 2011;19:30–35. Epub 2011/01/18. PubMed PMID: 21235657.
   PubMedGoogle Scholar
• Viberg N, Mujinja P, Kalala W, et al. STI management in Tanzanian private drugstores: practices and roles of drug sellers. Sex Transm Infect. 2009;85:300–307. Epub 2009/ 01/29. PubMed PMID: 19174423.
   PubMed Web of Science ®Google Scholar
• Larsson M, Odberg Pettersson K, Kashiha J, et al. Stretching the boundaries: Tanzanian pharmacy workers’ views and experiences of providing STI services for men who have sex with men. PloS One. 2016;11:e0166019. Epub 2016/ 11/05. PubMed PMID: 27812206; PubMed Central PMCID: PMCPMC5094583.
   PubMed Web of Science ®Google Scholar
• Agardh C, Weije F, Agardh A, et al. Using pharmacists and drugstore workers as sexual healthcare givers: a qualitative study of men who have sex with men in Dar es Salaam, Tanzania. Glob Health Action. 2017;10:1389181. Epub 2017/ 10/27. PubMed PMID: 29072110; PubMed Central PMCID: PMCPMC5678459.
   PubMed Web of Science ®Google Scholar
• Kushwaha S, Lalani Y, Maina G, et al. “But the moment they find out that you are MSM … ”: a qualitative investigation of HIV prevention experiences among men who have sex with men (MSM) in Ghana’s health care system. BMC Public Health. 2017;17:770. Epub 2017/10/05. PubMed PMID: 28974257; PubMed Central PMCID: PMCPMC5627492.
   PubMed Web of Science ®Google Scholar
• Creswell JW, Poth CN. Qualitative inquiry & research design: choosing among five approaches. Thousand Oaks, CA: SAGE Publications; 2017.
   Google Scholar
• National Bureau of Statistics, Ministry of Finance, Office of Chief Government Statistician President’s Office, Finance, Economy and Development Planning Zanzibar. Population distribution by age and sex. 2012 population and housing census. Dar es Salaam: Government of Tanzania; 2013. p. 1–400.
   Google Scholar
• Government of Tanzania. Tanzania Food, Drugs and Cosmetics Act, 2003. Dar es Salaam: Government of Tanzania; 2003.
   Google Scholar
• Minzi O, Manyilizu V. Application of basic pharmacology and dispensing practice of antibiotics in accredited drug-dispensing outlets in Tanzania. Drug Healthc Patient Saf. 2013;5:5–11. Epub 2013/02/14. PubMed PMID: 23403610; PubMed Central PMCID: PMCPMC3565572.
   Google Scholar
• Rutta E, Liana J, Embrey M, et al. Accrediting retail drug shops to strengthen Tanzania’s public health system: an ADDO case study. J Pharm Policy Pract. 2015;8:23. Epub 2015/ 09/29. PubMed PMID: 26413304; PubMed Central PMCID: PMCPMC4582893.
   PubMedGoogle Scholar
• Chalker JC, Vialle-Valentin C, Liana J, et al. What roles do accredited drug dispensing outlets in Tanzania play in facilitating access to antimicrobials? Results of a multi-method analysis. Antimicrob Resist Infect Control. 2015;4:33. Epub 2015/ 08/25. PubMed PMID: 26301089; PubMed Central PMCID: PMCPMC4545914.
   Web of Science ®Google Scholar
• Dahlgren L, Emmelin M, Winkvist A. Qualitative methodology for international public health. Umeå: Umeå University; 2007.
   Google Scholar
• Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24:105–112. Epub 2004/ 02/11. PubMed PMID: 14769454.
   PubMed Web of Science ®Google Scholar
• World Health Organization. The role of the pharmacist in the health care system. Geneva: World Health Organization; 1994.
   Google Scholar
• Hedley L, Panesar P. Play your part in managing syphilis. Pharm J. 2012;289:263.
   Google Scholar
• Lorenc T, Marrero-Guillamon I, Llewellyn A, et al. HIV testing among men who have sex with men (MSM): systematic review of qualitative evidence. Health Educ Res. 2011;26:834–846. Epub 2011/ 08/30. PubMed PMID: 21873612.
   PubMed Web of Science ®Google Scholar
• Bonner L. Pharmacists can be accessible, trusted providers for transgender patients. Pharm Today. 2016;22:57.
   Google Scholar
• Nyoni J, Ross MW. Factors associated with HIV testing in men who have sex with men, in Dar es Salaam, Tanzania. Sex Transm Infect. 2012;88:483. Epub 2012/06/30. PubMed PMID: 22745441.
   PubMed Web of Science ®Google Scholar
• Mgopa LR, Mbwambo J, Likindikoki S, et al. Violence and depression among men who have sex with men in Tanzania. BMC Psychiatry. 2017;17:296. Epub 2017/08/16. PubMed PMID: 28810838; PubMed Central PMCID: PMCPMC5558659.
   Web of Science ®Google Scholar
• Micheni M, Kombo BK, Secor A, et al. Health provider views on improving antiretroviral therapy adherence among men who have sex with men in Coastal Kenya. AIDS Patient Care STDS. 2017;31:113–121. Epub 2017/03/11. PubMed PMID: 28282249; PubMed Central PMCID: PMCPMC5359680.
   PubMed Web of Science ®Google Scholar
• Taegtmeyer M, Davies A, Mwangome M, et al. Challenges in providing counselling to MSM in highly stigmatized contexts: results of a qualitative study from Kenya. PloS One. 2013;8:e64527. Epub 2013/ 06/14. PubMed PMID: 23762241; PubMed Central PMCID: PMCPMC3676420.
   PubMed Web of Science ®Google Scholar
• van der Elst EM, Smith AD, Gichuru E, et al. Men who have sex with men sensitivity training reduces homoprejudice and increases knowledge among Kenyan healthcare providers in coastal Kenya. J Int AIDS Soc. 2013;16 Suppl 3:18748. PubMed PMID: 24321111.
   Web of Science ®Google Scholar
• van der Elst EM, Gichuru E, Omar A, et al. Experiences of Kenyan healthcare workers providing services to men who have sex with men: qualitative findings from a sensitivity training programme. J Int AIDS Soc. 2013;16 Suppl 3:18741. Epub 2014/01/01. PubMed PMID: 24321109; PubMed Central PMCID: PMCPMC3852126.
   Web of Science ®Google Scholar
• Kapoor R, Avendaño L, Sandoval MA, et al. Initiating a standardized regional referral and counter-referral system in Guatemala: a mixed-methods study. Glob Pediatr Health. 2017;4:2333794X17719205. PubMed PMID: PMC5528915.
   Google Scholar
• Shento AK. Strategies for ensuring trustworthiness in qualitative research projects. Educ Inf. 2004;22:63–75. PubMed PMID: 13857302.
   Google Scholar
• King RC, Fomundam HN. Remodeling pharmaceutical care in Sub-Saharan Africa (SSA) amidst human resources challenges and the HIV/AIDS pandemic. Int J Health Plann Manage. 2010;25:30–48. Epub 2009/ 04/24. PubMed PMID: 19387996.
   Web of Science ®Google Scholar
• BBC News. Tanzania threat to list gay people. BBC News Africa [Internet]. 2017 [cited 2017 Nov 7]. Available from: http://www.bbc.com/news/world-africa-39026477
   Google Scholar
• Tremblay S ‘Seeds of hate’ sown as Tanzania starts LGBT crackdown. The Guardian [Internet]. 2016 [cited 2017 Nov 7]. Available from: https://www.theguardian.com/world/2016/aug/08/seeds-of-hate-sown-as-tanzania-starts-lgbt-crackdown
   Google Scholar