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“We must help them despite who they are…”: healthcare providers’ attitudes and perspectives on care for young gay, bisexual and other men who have sex with men in Nairobi, Kenya

BACKGROUND: Compared to young heterosexual men, young gay, bisexual and other men who have sex with men (YMSM) face a disproportionate burden of sexual health conditions. This disparity is occasioned by factors such as criminalization and stigmatization of same-sex practices, YMSM’s limited access t...

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Autores principales: Mwaniki, Samuel Waweru, Kaberia, Peter Mwenda, Mugo, Peter Mwangi, Palanee-Phillips, Thesla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546658/
https://www.ncbi.nlm.nih.gov/pubmed/37789339
http://dx.doi.org/10.1186/s12913-023-10026-4
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author Mwaniki, Samuel Waweru
Kaberia, Peter Mwenda
Mugo, Peter Mwangi
Palanee-Phillips, Thesla
author_facet Mwaniki, Samuel Waweru
Kaberia, Peter Mwenda
Mugo, Peter Mwangi
Palanee-Phillips, Thesla
author_sort Mwaniki, Samuel Waweru
collection PubMed
description BACKGROUND: Compared to young heterosexual men, young gay, bisexual and other men who have sex with men (YMSM) face a disproportionate burden of sexual health conditions. This disparity is occasioned by factors such as criminalization and stigmatization of same-sex practices, YMSM’s limited access to non-judgmental and non-discriminatory health services, and challenges associated with healthcare delivery. We explored the attitudes and perspectives of tertiary academic institution-based healthcare providers (HCPs) toward provision of services to YMSM in Nairobi, Kenya. METHODS: In September 2021, six in-person focus group discussions (FGDs) were held with 36 HCPs drawn from six public tertiary academic institutions within the Nairobi metropolis. HCPs were drawn from six cadres: front office staff, nurses, clinicians, counsellors, laboratory technologists, and pharmaceutical technologists. Discussions were conducted in English, transcribed verbatim and analyzed thematically using NVivo version 12. RESULTS: Analysis showed that despite expressing disapproval of same-sex practices, HCPs recognized their professional duty to provide care to YMSM, voiced challenges they experienced when providing care to YMSM, and suggested possible strategies for improving care for YMSM. Disapproval of same-sex practices mainly stemmed from HCPs’ personal values, societal norms and religious beliefs, though some HCPs identified religious principles such as the golden rule of “treating others as one would want to be treated” as motivation to providing care to YMSM. HCPs did not perceive criminalization of same-sex practices as a barrier to providing care to YMSM. Healthcare delivery challenges included inadequate knowledge and skills, a desire to “convert” YMSM’s perceived deviant homosexual to the normative heterosexual orientation, secondary stigma from other HCPs, and healthcare settings that did not support YMSM to disclose same-sex practices. Suggestions for improving care comprised sensitization and training of HCPs, encouraging more HCP-YMSM interaction, providing YMSM-friendly and inclusive services, and advocacy for YMSM services. CONCLUSION: There is need for interventions to improve HCPs’ knowledge of YMSM’s health needs, build skills to respond to these needs, and foster affirming attitudes toward same-sex practices. By so doing, YMSM can hopefully be able to access services that meet their needs, and are non-discriminatory, non-stigmatizing and non-judgmental. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-10026-4.
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spelling pubmed-105466582023-10-04 “We must help them despite who they are…”: healthcare providers’ attitudes and perspectives on care for young gay, bisexual and other men who have sex with men in Nairobi, Kenya Mwaniki, Samuel Waweru Kaberia, Peter Mwenda Mugo, Peter Mwangi Palanee-Phillips, Thesla BMC Health Serv Res Research BACKGROUND: Compared to young heterosexual men, young gay, bisexual and other men who have sex with men (YMSM) face a disproportionate burden of sexual health conditions. This disparity is occasioned by factors such as criminalization and stigmatization of same-sex practices, YMSM’s limited access to non-judgmental and non-discriminatory health services, and challenges associated with healthcare delivery. We explored the attitudes and perspectives of tertiary academic institution-based healthcare providers (HCPs) toward provision of services to YMSM in Nairobi, Kenya. METHODS: In September 2021, six in-person focus group discussions (FGDs) were held with 36 HCPs drawn from six public tertiary academic institutions within the Nairobi metropolis. HCPs were drawn from six cadres: front office staff, nurses, clinicians, counsellors, laboratory technologists, and pharmaceutical technologists. Discussions were conducted in English, transcribed verbatim and analyzed thematically using NVivo version 12. RESULTS: Analysis showed that despite expressing disapproval of same-sex practices, HCPs recognized their professional duty to provide care to YMSM, voiced challenges they experienced when providing care to YMSM, and suggested possible strategies for improving care for YMSM. Disapproval of same-sex practices mainly stemmed from HCPs’ personal values, societal norms and religious beliefs, though some HCPs identified religious principles such as the golden rule of “treating others as one would want to be treated” as motivation to providing care to YMSM. HCPs did not perceive criminalization of same-sex practices as a barrier to providing care to YMSM. Healthcare delivery challenges included inadequate knowledge and skills, a desire to “convert” YMSM’s perceived deviant homosexual to the normative heterosexual orientation, secondary stigma from other HCPs, and healthcare settings that did not support YMSM to disclose same-sex practices. Suggestions for improving care comprised sensitization and training of HCPs, encouraging more HCP-YMSM interaction, providing YMSM-friendly and inclusive services, and advocacy for YMSM services. CONCLUSION: There is need for interventions to improve HCPs’ knowledge of YMSM’s health needs, build skills to respond to these needs, and foster affirming attitudes toward same-sex practices. By so doing, YMSM can hopefully be able to access services that meet their needs, and are non-discriminatory, non-stigmatizing and non-judgmental. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-10026-4. BioMed Central 2023-10-03 /pmc/articles/PMC10546658/ /pubmed/37789339 http://dx.doi.org/10.1186/s12913-023-10026-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Mwaniki, Samuel Waweru
Kaberia, Peter Mwenda
Mugo, Peter Mwangi
Palanee-Phillips, Thesla
“We must help them despite who they are…”: healthcare providers’ attitudes and perspectives on care for young gay, bisexual and other men who have sex with men in Nairobi, Kenya
title “We must help them despite who they are…”: healthcare providers’ attitudes and perspectives on care for young gay, bisexual and other men who have sex with men in Nairobi, Kenya
title_full “We must help them despite who they are…”: healthcare providers’ attitudes and perspectives on care for young gay, bisexual and other men who have sex with men in Nairobi, Kenya
title_fullStr “We must help them despite who they are…”: healthcare providers’ attitudes and perspectives on care for young gay, bisexual and other men who have sex with men in Nairobi, Kenya
title_full_unstemmed “We must help them despite who they are…”: healthcare providers’ attitudes and perspectives on care for young gay, bisexual and other men who have sex with men in Nairobi, Kenya
title_short “We must help them despite who they are…”: healthcare providers’ attitudes and perspectives on care for young gay, bisexual and other men who have sex with men in Nairobi, Kenya
title_sort “we must help them despite who they are…”: healthcare providers’ attitudes and perspectives on care for young gay, bisexual and other men who have sex with men in nairobi, kenya
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546658/
https://www.ncbi.nlm.nih.gov/pubmed/37789339
http://dx.doi.org/10.1186/s12913-023-10026-4
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