Men who have Sex with Men (MSM) in Kisumu, Kenya: Comfort in Accessing Health Services and Willingness to Participate in HIV Prevention Studies

Monday, 18 August 2014
Exhibit hall (Dena'ina Center)
Fredrick O Otieno, MPH , KEMRI/CDC Research and Public Health Collaboration, Kisumu, Kenya
Dancun A Okall, BA , KEMRI/CDC Research and Public Health Collaboration, Kisumu, Kenya
Kenneth O Ondeng'e, BA , KEMRI/CDC Research and Public Health Collaboration, Kisumu, Kenya
Monica W Nyambura, BS , KEMRI/CDC Research and Public Health Collaboration, Kisumu, Kenya
Felicia Hardnet, MPH , Centers for Disease Control and Prevention, Atlanta, GA
Kyle Turner, MPH , The University of Georgia, Athens, GA
Lisa A Mills, MD , Centers for Disease Control and Prevention, Atlanta, GA
Robert T Chen, MD , Centers for Disease Control and Prevention, Atlanta, GA
Deborah A Gust, PhD , Centers for Disease Control and Prevention, Atlanta, GA
INTRODUCTION:  MSM are a crucial and marginalized at risk population for HIV in Africa, and are not well studied.  Like other areas of Africa, homosexuality is illegal in Kenya.  Kisumu, Kenya is an area of high HIV prevalence. In this context, assessing MSM comfort in accessing health services and willingness to participate in HIV prevention research is important for HIV prevention efforts. The purpose of this study was to 1) describe the proportion and characteristics of MSM not comfortable seeking health services at a public hospital and 2) describe MSM motivators and barriers to participate in HIV research studies, including willingness to be contacted for an HIV study and acceptability of fingerprinting for study identification purposes.  

METHODS:  We conducted a two-phase study of MSM living in Kisumu Kenya that involved in-depth semi-structured interviews (n=15) and a structured survey (n=51) from 8th December 2010 through to 15th January 2011.  Exact logistic regression models were used for survey data analysis.  

RESULTS:  Over 60% (32/51) of survey participants were not very comfortable seeking health services from a public hospital (very comfortable: 37.3%; somewhat comfortable: 39.2%; not at all comfortable: 17.7%; do not seek services: 5.9%). Odds of having some discomfort in seeking health services (those who did not respond  “very comfortable”) were greater for men who felt like people were staring at them at the health clinic (OR=9.23; CI=1.73-95.45).   The main motivator for participating in an HIV research study was getting HIV education that could help prevent HIV; the main barrier was having their personal information made available to others in the community. The vast majority of MSM (49/51; 96.1%) reported willingness to be contacted to participate in future HIV research studies. Similarly, most (49/51; 96.1%) said fingerprinting for research purposes would be acceptable in Kisumu.

CONCLUSIONS:  Efforts to provide for safe and confidential health services and health education for MSM is required.  Further, continued community engagement of the MSM population in Kenya is needed to receive guidance regarding the best practices to involve this population in HIV prevention research.

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