Magesa Daniel J, Mtui Leah J, Abdul Mariam, Kayange Alick, Chiduo Rodney, Leshabari Melkizedek T, Kayombo Edmund, Tungaraza Dominicus
Tanzan J Health Res. 2014 Apr;16(2):118-26. doi: 10.4314/thrb.v16i2.8.
The HIV/AIDS disease burden is disproportionately high among men who have sex with men (MSM) worldwide. If this group will continue to be ignored they will continue to be the focus of HIV infection to the general population. This study explored barriers impeding MSM utilizing the HIV related health services currently available. The objectives of the study were to: (i) determine how stigma and discrimination affect MSM attendance to HIV related health services; (ii) determine how health care worker's (HCW's) practices and attitudes towards MSM affect their attendance to HIV related health service; (iii) learn MSM's perception towards seeking HIV related health services and other factors affecting accessibility of HIV related health services among MSM in Dar es Salaam, Tanzania. This was a descriptive study whereby qualitative methods were employed, using in-depth interviews for 50 individuals and focus group discussions for 5 groups which were conducted at PASADA premises, in Temeke district in 2012. After transcription data was read through, codes created were then collapsed into themes which were interpreted. The findings of this study show that majority of the study participants access HIV related health services in Dar es Salaam when they need to. However, they reported stigma and discrimination, lack of confidentiality and privacy, lack of availability and MSM friendly HIV related health services, financial challenges, poor practices and negative attitudes directed towards them by health workers, fears and lack of HIV knowledge among them as barriers for them to access these services. With these findings, there is an importance of enabling MSM to overcome the perceived stigma when seeking for HIV related health services. Also there is a need to conduct further research with regards to how HCW's treat this group and their understanding on same sex practices.
在全球范围内，男男性行为者（MSM）中的艾滋病毒/艾滋病疾病负担极高。如果这个群体继续被忽视，他们将继续成为普通人群中艾滋病毒感染的重点。本研究探讨了阻碍男男性行为者利用现有艾滋病毒相关健康服务的障碍。该研究的目的是：（i）确定耻辱感和歧视如何影响男男性行为者前往艾滋病毒相关健康服务机构就诊；（ii）确定医护人员对男男性行为者的做法和态度如何影响他们前往艾滋病毒相关健康服务机构就诊；（iii）了解坦桑尼亚达累斯萨拉姆的男男性行为者对寻求艾滋病毒相关健康服务的看法以及影响他们获得艾滋病毒相关健康服务的其他因素。这是一项描述性研究，采用了定性方法，于2012年在坦梅克区的PASADA场所对50人进行了深入访谈，并对5个小组进行了焦点小组讨论。转录后的数据经过通读，创建的代码随后被归纳为主题并进行了解释。本研究的结果表明，大多数研究参与者在需要时会在达累斯萨拉姆获得艾滋病毒相关健康服务。然而，他们报告称，耻辱感和歧视、缺乏保密性和隐私、缺乏可用的且对男男性行为者友好的艾滋病毒相关健康服务、经济挑战、医护人员对他们的不良做法和负面态度、他们自身的恐惧以及缺乏艾滋病毒知识是他们获得这些服务的障碍。基于这些发现，让男男性行为者在寻求艾滋病毒相关健康服务时克服所感受到的耻辱感非常重要。此外，有必要进一步研究医护人员如何对待这个群体以及他们对同性行为的理解。
