title: Experiences of Kenyan healthcare workers providing services to men who have sex with men: qualitative findings from a sensitivity training programme.
abstract: BACKGROUND
  Men who have sex with men (MSM) in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs) about the health issues and needs of MSM patients.
  
  
  METHODS
  Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs) with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs' challenges in serving MSM patients and impacts of programme participation on HCWs' personal attitudes and professional capacities.
  
  
  RESULTS
  Before participating in the training programme, HCWs described secondary stigma, lack of professional education about MSM, and personal and social prejudices as barriers to serving MSM clients. After completing the programme, HCWs expressed greater acknowledgement of MSM patients in their clinics, endorsed the need to treat MSM patients with high professional standards and demonstrated sophisticated awareness of the social and behavioural risks for HIV among MSM.
  
  
  CONCLUSIONS
  Findings provide support for this approach to improving health services for MSM patients. Further efforts are needed to broaden the reach of this training in other areas, address identified barriers to HCW participation and evaluate programme effects on patient and HCW outcomes using rigorous methodology.
authors: Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Nairobi, Kenya; Evanderelst@kemri-wellcome.org.
authors: Elise M
authors: EM
authors: van der Elst
authors: Evans
authors: E
authors: Gichuru
authors: Anisa
authors: A
authors: Omar
authors: Jennifer
authors: J
authors: Kanungi
authors: Zoe
authors: Z
authors: Duby
authors: Miriam
authors: M
authors: Midoun
authors: Sylvia
authors: S
authors: Shangani
authors: Susan M
authors: SM
authors: Graham
authors: Adrian D
authors: AD
authors: Smith
authors: Eduard J
authors: EJ
authors: Sanders
authors: Don
authors: D
authors: Operario
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003153:Community Health Services; D004501:Education, Medical; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission; D006282:Health Personnel / Q000523:psychology*; D018451:Homosexuality, Male; D006801:Humans; D007630:Kenya; D008297:Male; D011361:Professional Competence
keywords: HIV; Kenya; MSM; healthcare worker; on-line computer facilitated MSM sensitivity programme; stigma