Population Council Research that makes a difference

Abstract

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

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Background
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.

Methods
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.

Results
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.

Conclusions
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.

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