Department of Behavioural Sciences, 92976Department of Epidemiology and Biostatistics of the Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Global Health Section, Department of Public Health, 53139University of Copenhagen, Kobenhavn, Denmark.
J Int Assoc Provid AIDS Care. 2022 Jan-Dec;21:23259582221121448. doi: 10.1177/23259582221121448.
An increasing body of literature focuses on access to healthcare services for men who engage in sex with other men in Africa, but how healthcare workers conceive of this topic of healthcare workers' views on men's care has not been much studied. Drawing on qualitative research, this article explores healthcare providers' perspectives on access to HIV-related healthcare services among gender and sexuality diverse men in Tanzania. A qualitative study was conducted among healthcare workers in Dar es Salaam and Tanga, Tanzania in 2018/2019. Data collection entailed qualitative interviewing, focus group discussions and participant observation. A purposive sampling strategy was used to select study participants who varied with respect to age, education level, work experience, and the type and location of the facilities they worked in. A total of 88 participants took part in the study. This paper describes four different discourses that were identified among healthcare workers with respect to their perception of access to healthcare services for men who have sex with men. One held that access to healthcare was not a major problem, another that some same-sex attracted men did not utilize healthcare services although they were available to them, a third that some healthcare workers prevented these men from gaining access to healthcare and a fourth that healthcare for gender and sexual minority persons was made difficult by structural barriers. Although these are four rather different takes on the prevailing circumstances with respect to healthcare access for same-sex attracted men (SSAM), we suggest that they may all be "true" in the sense that they grasp and highlight different aspects of the same realities. More education is needed to healthcare providers to enable them accept SSAM who seek healthcare services and hence improve access to healthcare.
越来越多的文献关注非洲与男性发生性行为的男性获得医疗保健服务的问题，但医疗保健工作者对这一主题的看法——医疗保健工作者对男性护理的看法——并没有得到太多研究。本文借鉴定性研究，探讨了坦桑尼亚医疗保健提供者对不同性别和性取向的男性获得艾滋病毒相关医疗保健服务的看法。
2018/2019 年，在坦桑尼亚达累斯萨拉姆和坦噶进行了一项定性研究。数据收集包括定性访谈、焦点小组讨论和参与式观察。采用目的性抽样策略选择研究参与者，他们在年龄、教育水平、工作经验以及他们工作的设施类型和地点方面有所不同。共有 88 名参与者参加了这项研究。
本文描述了医疗保健工作者在他们对男男性行为者获得医疗保健服务的看法方面确定的四种不同论述。一种认为获得医疗保健不是一个主要问题，另一种认为虽然一些同性恋男性可以利用医疗保健服务，但他们并没有利用这些服务，第三种认为一些医疗保健工作者阻止这些男性获得医疗保健，第四种认为医疗保健对性别和性少数群体造成了障碍。
尽管这四种观点对男男性行为者（SSAM）获得医疗保健的普遍情况有不同的看法，但我们认为，从某种意义上说，它们都可能是“真实的”，因为它们抓住并突出了同一现实的不同方面。需要对医疗保健提供者进行更多的教育，使他们能够接受寻求医疗保健服务的 SSAM，从而改善医疗保健服务的可及性。
