Abstract #266  -  Get sick first test later: HIV testing practices of men who have sex with men (MSM) in the Johannesburg/eThekweni Mens Study (JEMS)
Authors:   Presenting Author:   Ms Allanise Cloete - Human Sciences Research Council
Additional Authors:  Prof Laetitia Rispel, Dr Carol Metcalf, Prof Vasu Reddy,
Aim: Low HIV testing uptake is a major obstacle to scaling-up HIV prevention and treatment services. HIV testing practices, access to HIV testing services, attitudes towards HIV testing and previous experiences of MSM with the health care sector were investigated as part of the Johannesburg/eThekwini Mens Study (JEMS).
Method / Issue: Thirty-two key informant interviews (KIIs) and focus group discussions (FGDs) with 156 MSM were conducted. HIV testing practices, access to HIV testing services and attitudes towards HIV testing were discussed. KIIs and FGDs were tape recorded. Audio-recorded interviews were transcribed verbatim, translated where necessary, and thematic analysis was used to analyse and interpret the data. All participants in this study took part voluntarily and anonymously, and signed consent forms beforehand.
Results / Comments: In general KIIs reported that health services are geared towards heterosexual people, and that health workers at publicly-funded clinics and hospitals are not well-versed at providing services adapted to MSM. Health workers generally assume heterosexuality. Several informants motivated for the establishment of specialised counselling services tailored specifically to MSM in order to address self-rejection, other forms of stigma, and fears about disclosure that are common among MSM. FGDs revealed that MSM are reluctant to test for HIV due to fear of HIV and of real or perceived discrimination based on both sexual orientation and HIV status. A lack of MSM-friendly clinics and judgmental attitudes among health care providers serve as additional barriers to seeking HIV testing. In addition to this the main source of information about HIV and AIDS is mainstreamed through national HIV prevention media campaigns, and is not necessarily geared to the specific HIV prevention needs of MSM.
Discussion: Targeted campaigns are needed to promote HIV testing among MSM. In order to scale-up HIV testing among MSM, voluntary counselling and testing (VCT) services need to be more MSM-friendly and attitudes of providers need to be addressed.
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