将药剂师和药店工作人员用作性健康护理提供者:对坦桑尼亚达累斯萨拉姆男男性行为者的定性研究。

Using pharmacists and drugstore workers as sexual healthcare givers: a qualitative study of men who have sex with men in Dar es Salaam, Tanzania.

作者信息

Agardh Charlotte, Weije Felicia, Agardh Anette, Nyoni Joyce, Ross Michael W, Kashiha John, Larsson Markus

机构信息

a School of Medicine, Faculty of Medicine , Lund University , Malmö , Sweden.

b Division for Social Medicine and Global Health, Department of Clinical Sciences, Malmö , Lund University , Malmö , Sweden.

出版信息

Glob Health Action. 2017;10(1):1389181. doi: 10.1080/16549716.2017.1389181.

Abstract

BACKGROUND

Previous research has shown that men who have sex with men (MSM) avoid formal healthcare services because of the fear of discrimination as homosexuality is illegal and stigmatized in Tanzania. Instead, self-treatment by medications obtained directly from pharmacies or drugstores may be common when MSM experience symptoms of suspected sexually transmitted infections (STIs) related to sexual activity with men.

OBJECTIVE

To explore MSM's perceptions and experiences of seeking treatment and advice from pharmacists and drugstore workers in Dar es Salaam, Tanzania, with regards to their sexual health and STI-related problems.

MATERIALS AND METHODS

15 in-depth interviews were conducted with MSM with experience of seeking assistance relating to their sexual health at pharmacies and drugstores in Dar es Salaam in 2016. A qualitative manifest and latent content analysis was applied to the collected data.

RESULTS

Four themes related to different aspects of MSM's perceptions and experiences of pharmacy care emerged from the analysis: (1) Balancing threats against need for treatment reflected informants' struggles concerning risks and benefits of seeking assistance at pharmacies and drugstores; (2) Identifying strategies to access required services described ways of approaching a pharmacist when experiencing a sexual health problem; (3) Seeing pharmacists as a first choice of care focused on informants' reasons for preferring contact with pharmacies/drugstores rather than formal healthcare services; and (4) Lacking reliable services at pharmacies indicated what challenges existed related to pharmacy care.

CONCLUSIONS

MSM perceived the barriers for accessing assistance for STI and sexual health problems at pharmacies and drugstores as low, thereby facilitating their access to potential treatment. However, the results further revealed that MSM at times received inadequate drugs and consequently inadequate treatment. Multi-facetted approaches are needed, both among MSM and drugstore, pharmacy, and healthcare workers, to improve knowledge of MSM sexual health, STI treatment, and risks of antibiotic resistance.

摘要

背景

先前的研究表明,在坦桑尼亚,男男性行为者(MSM)因担心受到歧视而避免寻求正规医疗服务,因为同性恋在该国是非法的且受到污名化。相反,当男男性行为者出现与男性性行为相关的疑似性传播感染(STI)症状时,直接从药店获取药物进行自我治疗可能很常见。

目的

探讨坦桑尼亚达累斯萨拉姆的男男性行为者在性健康和性传播感染相关问题上,向药剂师和药店工作人员寻求治疗和建议的认知与经历。

材料与方法

2016年,对15名有在达累斯萨拉姆的药店就性健康问题寻求帮助经历的男男性行为者进行了深入访谈。对收集到的数据采用了定性的显性和隐性内容分析法。

结果

分析得出了与男男性行为者对药店护理的认知和经历不同方面相关的四个主题:(1)权衡治疗需求与威胁反映了受访者在药店寻求帮助的风险和益处方面的挣扎;(2)确定获取所需服务的策略描述了在遇到性健康问题时接近药剂师的方式;(3)将药剂师视为首选护理对象侧重于受访者更喜欢与药店接触而非正规医疗服务的原因;(4)药店缺乏可靠服务指出了与药店护理相关的挑战。

结论

男男性行为者认为在药店获取性传播感染和性健康问题援助的障碍较低,从而便于他们获得潜在治疗。然而,结果进一步显示,男男性行为者有时会得到不充足的药物,因此治疗不充分。需要男男性行为者以及药店、药房和医护人员采取多方面的方法,以提高对男男性行为者性健康、性传播感染治疗以及抗生素耐药性风险的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21f6/5678459/5d9384f2513f/ZGHA_A_1389181_F0001_B.jpg

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