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Exploring access to HIV-related services and programmatic gaps for Men having Sex with Men (MSM) in rural India- a qualitative study

BACKGROUND: Despite the Link Worker Scheme to address the HIV risk and vulnerabilities in rural areas, reaching out to unreached men having sex with men (MSM) remains a challenge in rural India. This study explored issues around health care access and programmatic gaps among MSM in rural settings of...

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Autores principales: Bangar, Sampada, Mohan, Uday, Kumar, Sanjeev, Mahapatra, Amarendra, Singh, Shivendra Kumar, Kohli, Rewa, Verma, Archana, Katendra, Tuman Lal, Rahane, Girish, Shewale, Suhas P., Yenbhar, Nayana, Verma, Vinita, Saravanamurthy, P., George, Bitra, Kushwaha, Bhawani Singh, Das, Chinmoyee, Rajan, Shobini, Sahay, Seema
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10159193/
https://www.ncbi.nlm.nih.gov/pubmed/37141198
http://dx.doi.org/10.1371/journal.pone.0284901
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author Bangar, Sampada
Mohan, Uday
Kumar, Sanjeev
Mahapatra, Amarendra
Singh, Shivendra Kumar
Kohli, Rewa
Verma, Archana
Katendra, Tuman Lal
Rahane, Girish
Shewale, Suhas P.
Yenbhar, Nayana
Verma, Vinita
Saravanamurthy, P.
George, Bitra
Kushwaha, Bhawani Singh
Das, Chinmoyee
Rajan, Shobini
Sahay, Seema
author_facet Bangar, Sampada
Mohan, Uday
Kumar, Sanjeev
Mahapatra, Amarendra
Singh, Shivendra Kumar
Kohli, Rewa
Verma, Archana
Katendra, Tuman Lal
Rahane, Girish
Shewale, Suhas P.
Yenbhar, Nayana
Verma, Vinita
Saravanamurthy, P.
George, Bitra
Kushwaha, Bhawani Singh
Das, Chinmoyee
Rajan, Shobini
Sahay, Seema
author_sort Bangar, Sampada
collection PubMed
description BACKGROUND: Despite the Link Worker Scheme to address the HIV risk and vulnerabilities in rural areas, reaching out to unreached men having sex with men (MSM) remains a challenge in rural India. This study explored issues around health care access and programmatic gaps among MSM in rural settings of India. METHODS: We conducted eight Focused Group Discussions (FGDs), 20 Key Informant Interviews (KIIs), and 20 In-Depth Interviews (IDIs) in four rural sites in Maharashtra, Odisha, Madhya Pradesh, and Uttar Pradesh between November 2018 and September 2019. The data in the local language were audio-recorded, transcribed, and translated. Data were analyzed in NVivo version 11.0 software using the grounded theory approach. RESULTS: Primary barriers to health care access were lack of knowledge, myths and misconceptions, not having faith in the quality of services, program invisibility in a rural setting, and anticipated stigma at government health facilities. Government-targeted intervention services did not seem to be optimally advertised in rural areas as MSM showed a lack of information about it. Those who knew reported not accessing the available government facilities due to lack of ambient services, fear of the stigma transforming into fear of breach of confidentiality. One MSM from Odisha expressed, “…they get fear to go to the hospital because they know that hospital will not maintain confidentiality because they are local people. If society will know about them, then family life will be disturbed” [OR-R-KI-04]. Participants expressed the desire for services similar to those provided by the Accredited Social Health Activists (ASHA), frontline health workers for MSM. CONCLUSION: Programme invisibility emerges as the most critical issue for rural and young MSM. Adolescent and panthis emerged as Hidden MSM and they need focused attention from the programme. The need for village-level workers such as ASHA specifically for the MSM population emerged. MSM-friendly health clinics would help to improve healthcare access in rural MSMs under Sexual and Reproductive Health Care.
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spelling pubmed-101591932023-05-05 Exploring access to HIV-related services and programmatic gaps for Men having Sex with Men (MSM) in rural India- a qualitative study Bangar, Sampada Mohan, Uday Kumar, Sanjeev Mahapatra, Amarendra Singh, Shivendra Kumar Kohli, Rewa Verma, Archana Katendra, Tuman Lal Rahane, Girish Shewale, Suhas P. Yenbhar, Nayana Verma, Vinita Saravanamurthy, P. George, Bitra Kushwaha, Bhawani Singh Das, Chinmoyee Rajan, Shobini Sahay, Seema PLoS One Research Article BACKGROUND: Despite the Link Worker Scheme to address the HIV risk and vulnerabilities in rural areas, reaching out to unreached men having sex with men (MSM) remains a challenge in rural India. This study explored issues around health care access and programmatic gaps among MSM in rural settings of India. METHODS: We conducted eight Focused Group Discussions (FGDs), 20 Key Informant Interviews (KIIs), and 20 In-Depth Interviews (IDIs) in four rural sites in Maharashtra, Odisha, Madhya Pradesh, and Uttar Pradesh between November 2018 and September 2019. The data in the local language were audio-recorded, transcribed, and translated. Data were analyzed in NVivo version 11.0 software using the grounded theory approach. RESULTS: Primary barriers to health care access were lack of knowledge, myths and misconceptions, not having faith in the quality of services, program invisibility in a rural setting, and anticipated stigma at government health facilities. Government-targeted intervention services did not seem to be optimally advertised in rural areas as MSM showed a lack of information about it. Those who knew reported not accessing the available government facilities due to lack of ambient services, fear of the stigma transforming into fear of breach of confidentiality. One MSM from Odisha expressed, “…they get fear to go to the hospital because they know that hospital will not maintain confidentiality because they are local people. If society will know about them, then family life will be disturbed” [OR-R-KI-04]. Participants expressed the desire for services similar to those provided by the Accredited Social Health Activists (ASHA), frontline health workers for MSM. CONCLUSION: Programme invisibility emerges as the most critical issue for rural and young MSM. Adolescent and panthis emerged as Hidden MSM and they need focused attention from the programme. The need for village-level workers such as ASHA specifically for the MSM population emerged. MSM-friendly health clinics would help to improve healthcare access in rural MSMs under Sexual and Reproductive Health Care. Public Library of Science 2023-05-04 /pmc/articles/PMC10159193/ /pubmed/37141198 http://dx.doi.org/10.1371/journal.pone.0284901 Text en © 2023 Bangar et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Bangar, Sampada
Mohan, Uday
Kumar, Sanjeev
Mahapatra, Amarendra
Singh, Shivendra Kumar
Kohli, Rewa
Verma, Archana
Katendra, Tuman Lal
Rahane, Girish
Shewale, Suhas P.
Yenbhar, Nayana
Verma, Vinita
Saravanamurthy, P.
George, Bitra
Kushwaha, Bhawani Singh
Das, Chinmoyee
Rajan, Shobini
Sahay, Seema
Exploring access to HIV-related services and programmatic gaps for Men having Sex with Men (MSM) in rural India- a qualitative study
title Exploring access to HIV-related services and programmatic gaps for Men having Sex with Men (MSM) in rural India- a qualitative study
title_full Exploring access to HIV-related services and programmatic gaps for Men having Sex with Men (MSM) in rural India- a qualitative study
title_fullStr Exploring access to HIV-related services and programmatic gaps for Men having Sex with Men (MSM) in rural India- a qualitative study
title_full_unstemmed Exploring access to HIV-related services and programmatic gaps for Men having Sex with Men (MSM) in rural India- a qualitative study
title_short Exploring access to HIV-related services and programmatic gaps for Men having Sex with Men (MSM) in rural India- a qualitative study
title_sort exploring access to hiv-related services and programmatic gaps for men having sex with men (msm) in rural india- a qualitative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10159193/
https://www.ncbi.nlm.nih.gov/pubmed/37141198
http://dx.doi.org/10.1371/journal.pone.0284901
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