title: You become afraid to tell them that you are gay: health service utilization by men who have sex with men in South African cities.
abstract: We describe the utilization of health services by men who have sex with men (MSM) in South African cities, their perceptions of available health services, and their service preferences. We triangulated data from 32 key informant interviews (KIIs), 18 focus group discussions (FGDs) with MSM in four cities, and a survey of 285 MSM in two cities, recruited through respondent-driven sampling in 2008. FGDs and KIIs revealed that targeted public health sector programs for MSM were limited, and that MSM experienced stigma, discrimination, and negative health worker attitudes. Fifty-seven per cent of the survey participants had used public health services in the previous 12 months, and 69 per cent had no private health insurance, with no difference by HIV status. Despite these findings, South Africa is well placed to take the lead in sub-Saharan Africa in providing responsive and appropriate HIV services for MSM.
authors: Centre for Health Policy & Medical Research Council Health Policy Research Group, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Private Bag X3, Wits 2050, Johannesburg, South Africa. laetitia.rispel@wits.ac.za
authors: Laetitia C
authors: LC
authors: Rispel
authors: Carol A
authors: CA
authors: Metcalf
authors: Allanise
authors: A
authors: Cloete
authors: Julia
authors: J
authors: Moorman
authors: Vasu
authors: V
authors: Reddy
mesh_terms: D003625:Data Collection; D017144:Focus Groups; D015658:HIV Infections / Q000517:prevention & control / Q000628:therapy*; D006296:Health Services / Q000706:statistics & numerical data*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D007407:Interviews as Topic; D008297:Male; D010342:Patient Acceptance of Health Care; D013019:South Africa; D014505:Urban Population