Perceived barriers to access available health services among men who have sex with men in Dar es salaam .

Abstract

Men who have sex with men (MSM) continue to be highly affected with the HIV infection worldwide. Studies have shown that organization of health care system and how the MSM perceive it, play a major role in granting or denying them access to health care services. Little is known in Tanzania with regards to barriers of MSM accessing health services in Tanzania. The study was geared towards determining the proportion of MSM who accessed health care and disclose their sexual orientations to health care workers (HCW). It also intended to find out the anticipated barriers from HCW’s if they were to disclose their sexual orientations to them and look into the types of social networks used when facing various challenges. The study employed both quantitative and qualitative methods. Participants were enrolled in the study Respondent Driven Sampling .Quantitative data was entered and analyzed using the Statistical Package for the Social Sciences v.20. Qualitative data was collected using in-depth interviews read and interpreted to identify themes and create categories. These were manually analyzed and interpreted according to the study objectives. Majority of MSM (87.7%) in this study accessed health care services when sick, only 3.4% did nothing because they had no money to pay for the services. Only a third of them had ever disclosed their sexual orientations to HCW’s, due to perceived lack of confidentiality, fear of stigma and discrimination, shame and mistreatment at the health facilities and fear of HCW’s reaction after disclosure of their sexual orientations. MSM need to be empowered to overcome their perceived fears on HCW’s and health facilities. Efforts should be put in breaking the cycle of wrong information and perceptions MSM have on health care worker’s knowledge on dealing with same sex practices’ health related problems.