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You become afraid to tell them that you are gay: Health service utilization by men who have sex with men in South African cities

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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.

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Acknowledgements

The study was funded by the United Kingdom Department for International Development. This study would not have been possible without the support of many people, particularly Robin Gorna, Loraine Townsend, Yanga Zembe, Adrian Puren, Nonhlanhla Mkhize, and other members of the Johannesburg-eThekwini Men's Study Community Advisory Board.

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Authors and Affiliations

  1. 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, Johannesburg, 2050, Wits, South Africa

    Laetitia C Rispel

  2. Médecins Sans Frontières, Cape Town, South Africa

    Carol A Metcalf

  3. HIV/AIDS, STI and Tuberculosis Programme, Human Sciences Research Council, Cape Town, South Africa

    Allanise Cloete

  4. School of Public Health, University of the Witwatersrand, Johannesburg, South Africa

    Julia Moorman

  5. Human and Social Development Programme, Human Sciences Research Council, Pretoria, South Africa

    Vasu Reddy

Authors
  1. Laetitia C Rispel
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  2. Carol A Metcalf
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  3. Allanise Cloete
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  4. Julia Moorman
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  5. Vasu Reddy
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Corresponding author

Correspondence to Laetitia C Rispel.

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A study of health service utilization among men who have sex withmen (MSM) in South African cities found that targeted public health sector programs for MSM were limited, and MSM experienced stigma, discrimination, and negative health worker attitudes.

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Rispel, L., Metcalf, C., Cloete, A. et al. You become afraid to tell them that you are gay: Health service utilization by men who have sex with men in South African cities. J Public Health Pol 32 (Suppl 1), S137–S151 (2011). https://doi.org/10.1057/jphp.2011.29

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