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Health care in a homophobic climate: the SPEND model for providing sexual health services to men who have sex with men where their health and human rights are compromised

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dc.contributor.author Ross, M.W.
dc.contributor.author Nyoni, J.
dc.contributor.author Larsson, M.
dc.contributor.author Mbwambo, J.
dc.contributor.author Agardh, A.
dc.contributor.author Kashiha, J.
dc.contributor.author McCurdy, S.A.
dc.date.accessioned 2016-09-14T07:05:11Z
dc.date.available 2016-09-14T07:05:11Z
dc.date.issued 2015-02
dc.identifier.citation Ross MW, Nyoni J, Larsson M, Mbwambo J, Agardh A, Kashiha J, McCurdy SA. Health care in a homophobic climate: the SPEND model for providing sexual health services to men who have sex with men where their health and human rights are compromised. Global health action. 2015 Mar 17;8. en_GB
dc.identifier.uri http://dx.doi.org/10.3402/gha.v8.26096
dc.identifier.uri http://hdl.handle.net/123456789/2043
dc.description.abstract We present a model for developing health services for men who have sex with men (MSM) in sub-Saharan Africa and other places where MSM are heavily stigmatized and marginalized. The processes of the SPEND model include Safe treatment for sexually transmissible infections (STIs) and HIV; Pharmacy sites for treatment of STIs in countries where pharmacies and drug stores are the source of medical advice and treatment; Education in sexual health issues for health professionals to reduce discrimination against MSM patients; Navigation for patients who have HIV and are rejected or discriminated against for treatment; and Discrimination reduction through educating potential leaders in tertiary education in issues of human sexuality. Supporting empirical evidence from qualitative and quantitative studies is summarized, and barriers to implementation are discussed. Health care for MSM is one of the casualties of anti-homosexual social and legal climates. There is no amnesty for MSM in health care settings, where the stigma and discrimination that they face in the rest of society is replicated. Such conditions, however, make it necessary to consider ways of providing access to health care for MSM, especially where rates of HIV and STIs in MSM populations are high, and stigma and discrimination encourages high proportions ofMSM to marry. This in itself enhances the status of MSM as an important bridge population for STIs including HIV. Where anti-homosexual laws encourage, or are believed to encourage, the reporting of MSM to authorities, health care may be seen as an agent of authority rather than an agency for care. en_GB
dc.language.iso en en_GB
dc.publisher Global Health Action en_GB
dc.relation.ispartofseries Global Health Action;
dc.subject Men who have sex with men (MSM) en_GB
dc.subject Discrimination en_GB
dc.subject Africa en_GB
dc.subject STIs en_GB
dc.title Health care in a homophobic climate: the SPEND model for providing sexual health services to men who have sex with men where their health and human rights are compromised en_GB
dc.type Article en_GB


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