scholarly journals Structural barriers to HIV prevention among men who have sex with men (MSM) in Vietnam: Diversity, stigma, and healthcare access

PLoS ONE ◽  
2018 ◽  
Vol 13 (4) ◽  
pp. e0195000 ◽  
Author(s):  
Morgan M. Philbin ◽  
Jennifer S. Hirsch ◽  
Patrick A. Wilson ◽  
An Thanh Ly ◽  
Le Minh Giang ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Healthcare Access ◽  
Structural Barriers ◽  
Sex With Men

scholarly journals How men who have sex with men experience HIV health services in Kampala, Uganda

2020 ◽  
Vol 5 (4) ◽  
pp. e001901
Author(s):  
Rachel King ◽  
Zubayiri Sebyala ◽  
Moses Ogwal ◽  
George Aluzimbi ◽  
Rose Apondi ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Health Services ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Health Staff ◽  
Structural Factors ◽  
Structural Barriers ◽  
Sub Saharan ◽  
Sex With Men

In sub-Saharan Africa, men who have sex with men (MSM) are socially, largely hidden and face disproportionate risk for HIV infection. Attention to HIV epidemics among MSM in Uganda and elsewhere in sub-Saharan Africa has been obscured by repressive governmental policies, criminalisation, stigma and the lack of basic epidemiological data describing these epidemics. In this paper, we aim to explore healthcare access, experiences with HIV prevention services and structural barriers to using healthcare services in order to inform the acceptability of a combination HIV prevention package of services for men who have sex with men in Uganda. We held focus group discussions (FGDs) with both MSM and healthcare providers in Kampala, Uganda, to explore access to services and to inform prevention and care. Participants were recruited through theoretical sampling with criteria based on ability to answer the research questions. Descriptive thematic coding was used to analyse the FGD data. We described MSM experiences, both negative and positive, as they engaged with health services. Our findings showed that socio-structural factors, mediated by psychological and relational factors impacted MSM engagement in care. The socio-structural factors such as stigma, homophobia and policy issues emerged strongly as did the mediating factors such as relations with specific health staff and a social support structure. A combination intervention addressing structural, social and psychological barriers could have an impact even in the precarious policy environment where this study was conducted.

Influence of stigma and homophobia on mental health and on the uptake of HIV/sexually transmissible infection services for Cameroonian men who have sex with men

Sexual Health ◽  
2015 ◽  
Vol 12 (4) ◽  
pp. 315 ◽  
Author(s):  
Charles W. Cange ◽  
Matthew LeBreton ◽  
Serge Billong ◽  
Karen Saylors ◽  
Ubald Tamoufe ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Physical Violence ◽  
Qualitative Interviews ◽  
Healthcare Access ◽  
Healthcare Setting ◽  
Hiv Treatment ◽  
Mental Wellbeing ◽  
Public Healthcare ◽  
Treatment Cascade ◽  
Sex With Men

Background Men who have sex with men (MSM) in Cameroon consistently face significant stigma and discrimination. The urban HIV prevalence in MSM is estimated at 35%. This study investigates the effect of stigma, discrimination and alienation on Cameroonian MSM’s engagement of the HIV treatment cascade. Methods: Qualitative interviews were semi-structured using a guide. Participants in Douala, Ngaoundere, Bamenda, Bertoua and Yaoundé were asked to describe the MSM social and structural context, MSM knowledge of existing HIV-related services in public and MSM-focussed non-governmental organisation (NGO) clinics. Using a codebook, coded text was extracted from 40 transcripts with Microsoft Word Macros. These texts were analysed for recurring themes that were developed into results. Results: There were three main themes that emerged. First, among those MSM participants seeking HIV services, many commonly reported experiences of discrimination and physical violence outside the healthcare setting. Second, a few respondents used services provided by the Ministry of Health and local NGOs. However, most participants observed limited clinical and cultural competency of public clinic staff. Third, MSM declared that lack of social support and healthcare access caused them much stress. Several individuals recounted their alienation greatly discouraged them from seeking HIV prevention, treatment and care services. Conclusions: Community-level and public healthcare-related stigma impacts the mental wellbeing of Cameroonian MSM. Alienation among MSM also represents a common obstacle to the uptake of MSM-oriented HIV/AIDS services. Improving provider cultural and clinical competency among Cameroonian health care workers combined with a broader stigma-reduction intervention for Cameroonian healthcare may increase the uptake of HIV prevention, treatment and care among MSM.

scholarly journals Awareness and Use of Post-exposure Prophylaxis for HIV Prevention Among Men Who Have Sex With Men: A Systematic Review and Meta-Analysis

2022 ◽  
Vol 8 ◽  
Author(s):  
Junyan Jin ◽  
Runsong Sun ◽  
Tingting Mu ◽  
Taiyi Jiang ◽  
Lili Dai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Prevention ◽  
Meta Analysis ◽  
Post Exposure Prophylaxis ◽  
Structural Barriers ◽  
Post Exposure ◽  
At Risk Populations ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Over Time

Background: The use of post-exposure prophylaxis (PEP) is effective in reducing HIV risk, but it is underused by men who have sex with men (MSM) due to certain psychological and sociostructural factors. This article assessed the awareness and use of PEP among MSM in an effort to increase the visibility and uptake of PEP among at-risk populations.Methods: We conducted a systematic literature search of the PubMed, Web of Science, PsycINFO, and Google Scholar electronic databases. Studies were screened for inclusion, and relevant data were abstracted, assessed for bias, and synthesized. Pooled effect estimates were calculated using random effects meta-analysis, meta-regression and subgroup analysis, and a qualitative review and risk of bias assessment were performed (PROSPERO, CRD42019123815).Results: Twenty eligible studies involving 12,579 MSM were included in the meta-analysis. The pooled estimate of the proportions of MSM who were aware of PEP was modest at 59.9% (95% CI: 50.5~68.7) and that of MSM who previously used PEP was very low at 4.9% (95% CI: 2.4~9.8). PEP awareness showed no clear change over time, while PEP use significantly changed over time. Multiple factors affected awareness, including educational attainment, race/ethnicity, levels of HIV stigma, access to condoms, and so on. Many factors could potentially impede or facilitate the use of PEP, such as income, lack of PEP information, and partnership.Conclusion: We observed that PEP is an underused HIV prevention strategy among MSM and that once MSM become aware of PEP, the majority are willing to use it if they are supported appropriately in terms of a range of individual, social, and structural barriers.Systematic Review Registration: http://www.cdr.york.ac.uk/prospero, PROSPERO [CRD42019123815].

Love and Intimacy as Vulnerability to HIV Infection: A Case Study of MSM

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Archana Kaushik
Keyword(s):  
Hiv Infection ◽  
Cultural Values ◽  
Sexual Behaviors ◽  
Sex Workers ◽  
Sexual Minorities ◽  
Suicide Attempts ◽  
Service Providers ◽  
Structural Barriers ◽  
Health Seeking ◽  
Sex With Men

Sexual minorities are among the most marginalized groups in the society. Sero-positivity accentuates social exclusion among the sexual minorities. The paper aims to appraise the factors that make Men who have Sex with Men (MSM) vulnerable to HIV infection and influence their health seeking behaviors. It highlights two major domains socio-cultural and interpersonal variables. Qualitative in nature and based on ten in-depth case studies of HIV infected MSM, the study is located in Delhi, India. Factors such as age, marital status, child sexual abuse, multiple sex partners, are crucial in influencing their vulnerability. Socio-cultural milieu puts structural barriers restricting integration of MSM in the society. Cultural values do not allow talking about sex, which hampers healthy sexual behaviors. Exhibiting aggression, sexual violence, visiting sex-workers etc. are considered as important aspects to prove manhood. At the interpersonal level, possessiveness, betrayal, infidelity, heartbreak, strong emotional whirlpool when love-relations go incongruent, all takes a heavy toll of their mental and physical health. These variables socially exclude the sexual minorities from the mainstream life. Findings show positive (disclosing to family, abstinence, spiritual growth) and negative (suicide-attempts, drug-use) ways of coping among the MSM respondents. Critical areas of concern for service-providers while planning interventions for empowering people with sexual minority are delineated.

Measuring Acceptability and Engagement of the Keep It Up! Internet-based HIV Prevention Randomized Controlled Trial for Young Men who have Sex with Men (Preprint)

2018 ◽  
Author(s):  
Krystal Madkins ◽  
David Moskowitz ◽  
Kevin Moran ◽  
Trey Dellucci ◽  
Brian Mustanski
Keyword(s):  
High School ◽  
Randomized Controlled Trial ◽  
Hiv Prevention ◽  
Controlled Trial ◽  
P Values ◽  
Randomized Controlled ◽  
Increased Risk ◽  
Intervention Acceptability ◽  
Intervention Content ◽  
Sex With Men

BACKGROUND Since 2010, HIV diagnoses among men who have sex with men (MSM) have remained stably high while decreasing for heterosexual men and women. The burden of infection has disproportionately impacted younger MSM of color relative to other populations. Despite the increased risk, there are few HIV prevention programs targeted to diverse and young MSM. The Keep It Up! (KIU!) online intervention was created to address the HIV prevention needs of this population. OBJECTIVE The objective of this study was to examine the acceptability and engagement of KIU!, and explore any differences by demographics, within the context of a randomized controlled trial (RCT). METHODS Between May 2013 and December 2015, 445 participants were randomized into the intervention arm of the KIU! RCT. Data were taken from the baseline assessment, KIU! 2.0 intervention modules, and immediate post-test assessments of intervention acceptability and engagement. Outcomes of interests were qualitative and quantitative measures of intervention acceptability and engagement as well as process measures (i.e., star ratings of intervention content and paradata on time spent in intervention). RESULTS Participants were an average of 24 years old, 62.9% (280/445) identified as a racial or ethnic minority, 86.5% (385/445) identified as gay, and 84.3% (375/445) reported having at least some college education. Most participants rated the intervention content highly (4 out of 5 stars) and gave the intervention an average acceptability score of 3.5 out of 4. Compared to White participants, Black participants found the intervention more useful (p = .03), engaging (p < .001), and acceptable (p = .001); Latino participants found the intervention more engaging (p = .03); and “other” non-White participants found the intervention more engaging (p = .008) and acceptable (p = .02). Participants with high school or less education found the intervention more useful, engaging, and acceptable, and were more likely to give intervention content a five star rating than college educated participants (p-values = .047, <.001, .002, .01 respectively) or those with graduate degrees (p-values = .04, .001, < .001, .004 respectively). White participants showed the most variation between education levels and reporting positive attitudes towards the intervention. Among Black participants, graduate degree-earning participants spent significantly more time on the intervention than high-school or less educated participants (p = .02). CONCLUSIONS Overall, participants gave the intervention high acceptability and engagement ratings; but it was most acceptable and engaging to participants who were younger, identified as racial and ethnic minorities, had less education, and lived in the South. As these are all groups with greater burden of HIV infection, the KIU! intervention is promising as a primary HIV prevention tool. Future implementations of KIU! are needed to assess its acceptability outside of the highly controlled environment of an RCT. CLINICALTRIAL RCT# NCT01836445

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