Factors influencing utilisation of wellness centre services among men who have sex with men in Tumaini wellness centres, Kisumu and Awendo towns, Kenya

Abstract

Background: Men who have sex with men (MSM) are a crucial and marginalised at risk population for HIV in Africa but have not in the past been given a lot of attention. Like other areas of Africa, homosexuality is illegal in Kenya and hence most gay and other same-sex practicing Kenyans live in highly stigmatising and discriminatory settings, which put them at risk of emotional and/or physical harm.
Objective:To determine factors influencing utilisation of Wellness Centre services by Men who have Sex with Men inTumaini Wellness Centres in Kisumu and Awendo towns.
Design:A retrospective Cohort Study.
Setting: TumainiWellness centre in Kisumu and Awendo towns between 2012 and 2015.
Subjects:Three hundred and fifty three Men who have sex with men who had been enrolled in the Wellness Centre in Kisumu City and Awendo town between 2012 and 2015.
Results:The study used consecutive sampling to select a sample size of 198 MSM. However, the study obtained 353 responses, which gives a response rate of more than 100%. The association between current utilization of Wellness Center services and
independent variables (uptake of STI screening service, condom uptake, uptake of Alcohol and Drug use and uptake of Risk reduction counselling) were assessed by use of chi-square. The results show that the factors influencing Screening for STIs in wellness centres include marital status (p=0.0398), Town of residence (p=0.002), knowledge on the correct use of the condom (p=0.016), HTC counselling (p=0.013) and receiving of results (p=0.013). In addition, factor influencing condom distribution in the wellness centres include knowledge on the correct use of condoms (p=0.0001), consistent use of condoms (p=0.001), negotiating of condom use with regular partner and casual partner (p=0.001) and alcohol influence (p=0.016). The study also established that factors that significantly influence uptake of alcohol and drug use screening services were drug use in the past 30 days (p=0.017) and HTC counselling (p=0.039). It was also established that HTC counselling (p=0.001), receiving of HIV results (p=0.0013) and negotiation for condom use with regular partner and casual partners (p=0.008) influence the uptake of risk reduction counselling were age of the MSM.
Conclusion: Age of MSM, knowledge on condom use, Alcohol use and HTC results are some of the factors that influence uptake of Wellness Centre Services. This study recommends that governmental organisations such as NASCOP should setup wellness centres that cater for high risk groups like men who have sex with men to offer treatment and specialised counselling as part of HTS and STI services that is confidential and sensitive to the needs of men who have sex with men. In addition, both governmental and non-governmental organizations should increase the coverage
of HTC by establishing more MSM friendly centres. In addition, the governmental and non-governmental organisations should seek to integrate HTC services and STIs screening in wellness centres.