你害怕告诉他们你是同性恋：南非城市男男性行为者的卫生服务利用情况。

You become afraid to tell them that you are gay: health service utilization by men who have sex with men in South African cities.

机构信息

Centre for Health Policy & Medical Research Council Health Policy Research Group, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Private Bag X3, Wits 2050, Johannesburg, South Africa.

出版信息

J Public Health Policy. 2011;32 Suppl 1:S137-51. doi: 10.1057/jphp.2011.29.

DOI:10.1057/jphp.2011.29

PMID:21730987

Abstract

We describe the utilization of health services by men who have sex with men (MSM) in South African cities, their perceptions of available health services, and their service preferences. We triangulated data from 32 key informant interviews (KIIs), 18 focus group discussions (FGDs) with MSM in four cities, and a survey of 285 MSM in two cities, recruited through respondent-driven sampling in 2008. FGDs and KIIs revealed that targeted public health sector programs for MSM were limited, and that MSM experienced stigma, discrimination, and negative health worker attitudes. Fifty-seven per cent of the survey participants had used public health services in the previous 12 months, and 69 per cent had no private health insurance, with no difference by HIV status. Despite these findings, South Africa is well placed to take the lead in sub-Saharan Africa in providing responsive and appropriate HIV services for MSM.

摘要

我们描述了南非城市男男性行为者（MSM）利用卫生服务的情况、他们对现有卫生服务的看法以及他们的服务偏好。我们对 2008 年通过应答者驱动抽样在两个城市招募的 32 名关键知情人访谈（KII）、四个城市的 18 次男男性行为者焦点小组讨论（FGD）和 285 名男男性行为者的调查数据进行了三角分析。FGD 和 KII 显示，针对男男性行为者的有针对性的公共卫生部门方案有限，而且男男性行为者遭受污名化、歧视和卫生工作者的负面态度。在过去 12 个月内，57%的调查参与者使用过公共卫生服务，69%的人没有私人医疗保险，艾滋病毒状况没有差异。尽管存在这些问题，南非在撒哈拉以南非洲地区处于领先地位，为男男性行为者提供了有针对性和适当的艾滋病毒服务。