Perceived barriers to access available health services among men who have sex with men in Dar es Salaam, Tanzania

Abstract

Background: Men who have sex with men (MSM) continue to be highly affected with the HIV infection worldwide. Studies have shown that the organization of healthcare systems and how the MSM perceive it play a major role in granting or denying them access to healthcare services. Little is known in Tanzania regarding the barriers that MSM face while accessing health services within the country. The study was geared towards determining the proportion of MSM who accessed health care and disclose their sexual orientations to health care workers (HCW). It also intended to find out the anticipated barriers from HCW’s if they were to disclose their sexual orientations to them and consider the types of social networks used when facing various challenges.

Methods: The study employed both quantitative and qualitative methods. Participants were enrolled in the study Respondent Driven Sampling. Quantitative data was entered and analysed using the Statistical Package for the Social Sciences v.20. Qualitative data was collected using in-depth interviews read and interpreted to identify themes and create categories. These were manually analysed and interpreted according to the study objectives.

Results: The majority (87.7%) of MSM accessed healthcare services when sick, only a few (3.4%) did nothing due to lack of financial resources. Only a third of them had ever disclosed their sexual orientations to healthcare workers. This was due to lack of confidentiality, fear of stigma and discrimination, shame and mistreatment at the health facilities, and fear of the healthcare worker’s reaction after they disclosed their sexual orientation to them.

Conclusion: MSM need to be empowered to overcome their perceived fears towards healthcare workers and health facilities. Efforts should be put into breaking the cycle of negative information and perceptions MSM have about healthcare workers and how they deal with same sex practices’ health related problems.