Amsterdam 2015
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| Abstract #2196 - Cape to Casablanca: MSM in Africa | ||||
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Session: 20.9: Cape to Casablanca: MSM in Africa (Parallel) on Wednesday @ 16.30-18.00 in C104 Chaired by Theo Sandfort, Mike Ross Authors: Presenting Author: Mr Evanson Gichuru - KEMRI-Wellcome Trust Research Programme, Kenya |
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| Additional Authors: | ||||
| Aim: To develop a programme for Most Appropriate Service delivery for MSM and health care worker training in Africa | ||||
| Method / Issue: Issues: Most front-line health care providers (HCP) are not sensitised to the health care needs of men who have sex with men (MSM) in Africa. This reduces HCP’s ability to offer quality HIV prevention and care services to MSM communities. In response, MSM, while seeking health care, rarely take the opportunity to discuss specific MSM needs, as they often feel stigmatized or discriminated against. | ||||
| Results / Comments: Project: Jointly with the National AIDS & STD Control Programme in Kenya, we set up a free 8-modular online MSM sensitivity training (www.marps.africa.org) with over 1150 Kenyan HCP graduating from it since 2011. In Coastal Kenya, we offer online training for groups of around 20 HCP at the research centre’s computer-lab sessions that are facilitated by our own staff and 2-3 trained members of the Gay, MSM and Transgender (GMT) community. Since July 2014, this training programme has been expanded to include 1): Follow-up HCP training sessions at the -in centre of a research clinic serving MSM and FSW 2) Sessions especially designed for mobilised MSM and FSW offering HIV information and testing, with a view of detecting undiagnosed HIV- infection and linking those infected, and their partners to care 3).Training of members of GMT communities to extend HIV prevention and access to care services to their members, and 4) Community engagement of research clinic stakeholders, in particular religious leaders, to safeguard MSM and FSWs access to health-care. In the past 9 months, we have 1) trained 23 HCP in follow-up and 98 HCP in interactive computer-lab sessions 2) mobilized over 630 young adult MSM (10% HIV prevalence) and 330 FSW (11% HIV prevalence) 3) Discussed MSM research findings with various GMT groups and 4) Engaged over 680 stakeholders of the research clinic, including 50 religious leaders. Recently, we have designed in-facility sessions, in which MSM are mobilized to a health care facility with trained HCP. The mobilised groups are then counselled and tested for HIV by the trainees at that facility-interactions intended to aid MSM and their HCP overcome their fear of each other and of health-care seeking. | ||||
| Discussion: Lessons learned Community engagement is a continuing process that requires responsive and flexible strategies involving many stakeholders, including HCP, GMT-members, religious leaders and researchers to facilitate both improved understanding of and actual access to health care for MSM and FSW. While the initial sensitivity training reached many HCP in Kenya, an enriched training has been facilitated by MSM themselves allowing for real-life interactions and shared experiences to build confidence of HCP in serving MSM. A further improvement appears to come from in-facility meetings allowing MSM and FSW to interact with trained HCP. Given the high HIV-prevalence among MSM and FSW these in-facility meetings followed by HIV-testing allow for linkage to care and improved retention. ‘Nothing for us, without us’ remains a poignant call to action, and the involvement of MSM and FSW in identifying innovative strategies for their meaningful and effective engagement with health systems must be actively encouraged and sought for. | ||||
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