Where do men who have sex with men (MSM) go for health services in South Africa?
Oral poster discussion at the XVIII International AIDS Conference, Vienna, 21 July
Sheehy,Meredith; Tun,Waimar; Nel,Dawie; Fipaza,Zukiswa; Lung Vu
Publication date: 2010
Ensuring that MSM in African countries have universal access to HIV and STI prevention services is critical to effective HIV prevention programming for this important risk group. Understanding health-seeking behaviors of MSM can guide program implementers in improving service delivery to this population.
A cross-sectional survey was performed with 339 MSM recruited through respondent-driven sampling in greater Pretoria, South Africa. Survey questions included demographics, sexual history, HIV-related attitudes and beliefs, health-seeking behavior, and sexual identity.
66 percent of MSM were aged 18-25, 90 percent were black, 69 percent lived in a township, and 74 percent identified as gay. Half of MSM (54%) regularly accessed health care at private facilities and half at government facilities (47%). MSM accessing private facilities were significantly more likely to be non-township MSM (80% vs. 40%), gay-identified (57% vs. 44%), 25 or younger (59% vs. 43%), and have a steady sex partner (50% vs. 46%). Overall, MSM indicated high levels of trust in private and public providers to provide good care for patients (91% and 78%, respectively). However, 40 percent indicated they would not feel comfortable seeking care for STIs or getting tested for HIV at a government facility. Non-township MSM were significantly more likely to be uncomfortable going to a government facility for these services compared to MSM from townships (61% vs. 33% for STI services; 59% vs. 31% for HIV testing). Virtually all respondents reported they would feel comfortable at a private facility for STI treatment and HIV testing.
With half of MSM regularly accessing health services from government facilities, there is a strong need to improve the quality of these services in government facilities for MSM. With most in-town MSM currently accessing private health care, building capacity among private providers to deliver appropriate and tailored HIV and STI prevention services for MSM is critical.