Barriers and Facilitators in Accessing HIV Prevention Services for Men Having Sex with Men (MSM): A Comprehensive Analysis

Abstract

Objectives: This study explores MSM’s perspective on HIV prevention needs, barriers, facilitators, and retention strategies in prevention programs.

Method: In-depth interviews, key informant interviews, focus group discussions, and structured questionnaires were used to interview urban and rural Nigerian men having sex with men (MSM) aged 18 and older. Candidates were recruited using snowball referrals. Data analysis used IBM-SPSS 28.

Result: Urban residents (67.6%) had more secondary education than rural residents (53.7%) in the 299 MSM research. Drug use was 84.2% in urban and 61.3% in rural MSM. The majority of rural MSM (90.1%) had multiple sexual partners, unlike urban residents (70.1%). Compared to rural people (8.0%), urban MSM reported greater sexual abuse rates (22.0%). Over 80% of MSM used condoms, attended HIV meetings, visited STI clinics, and used lubricant. However, less than 80% would attend a peer-led clinic or have peers assist with drug adherence. MSM attending private healthcare facilities stated that distance to service delivery points was a major barrier (60.6%). However, those attending public health facilities cited lack of information (67.0%), unpleasant facilities (76.1%), stigma (81.8%), and incapacity to handle police harassment (74.4%) as key hurdles to treatment. MSM views on HIV preventive programs are examined in this qualitative study. Despite economic limits, respondents preferred private hospitals due to confidentiality, stigmatisation, and discrimination difficulties at public hospitals, which hinder treatment acceptance.

Conclusion: MSM in urban and rural settings have different HIV risk behaviours and access issues, requiring specific interventions.