Access to health services for men who have sex with men and transgender women in Beira, Mozambique: A qualitative study.

摘要: OBJECTIVES HIV prevalence and incidence are higher among key populations including Men who have Sex with (MSM) transgender women in low middle income countries, when compared to the general population. Despite World Health Organisation guidelines on provision of services recommending an evidence-based, culturally relevant rights-based approach, uptake many resource-limited rights-constrained settings remains low. Medecins Sans Frontieres (MSF) has been offering health for MSM Beira, Mozambique since 2014 using a peer-educator driven model, but not as high expected. This qualitative study aimed learn more about these their experiences accessing MSM- transgender-friendly use face-to-face virtual networks, social media, engagement care. METHODS In-depth interviews were carried out 1) enrolled in, 2) disengaged from or 3) never engaged MSF's programme. Purposive snowball sampling used recruit different groups interviewees. Interviews conducted Portuguese, transcribed translated into English before being coded manually analysed thematic network framework. RESULTS Nine 18 cisgender participated study. Interviewees ranged age 19 47 years, median 29. Three main themes emerged data: perceptions stigma discrimination, model platforms communication engagement, media. reported experiencing discrimination because gender sexual identity. HIV-related health-care setting gossip breach confidentiality, also reported. Although presence peer-educators outreach activities appreciated, they had limited visibility over-focus HIV. The networks small fragmented. Virtual such Facebook mainly flirting, dating informal communication. Most interviewees at ease media would consider it means engaging messaging. CONCLUSIONS challenges due stigmatised identity behaviour, often experience home, facilities communities. Peer-driven models appreciated limitations. There is untapped potential further expansion reach burden, provide them essential information health.