Electronic Media Access and Use for Sexuality and Sexual Health Education Among Men Who Have Sex With Men in Four Cities in Tanzania

Changing men or changing health systems? A scoping review of interventions, services and programmes targeting men’s health in sub-Saharan Africa

“…For example, many studies in this group explored the way masculinity and men’s specific knowledge, attitudes or perceptions in relation to diverse health issues including TB, HIV and family planning, influenced their engagement with specific health services [ 33 , 35 , 40 , 52 , 54 , 77 ]. Other studies aimed to identify facilitators and barriers to men’s engagement with health programmes [ 36 , 41 , 85 ] and described men’s health practices and utilisation of health services [ 48 , 60 , 71 ]. Additionally, a few studies in this category provided details on men’s care pathways for specific diseases including symptoms recognition, decision making process, choice of and access to care [ 65 , 66 , 86 ].…”

“… Majority of interventions were either gender neutral ( n = 4) [ 32 , 53 , 55 , 58 ] or gender sensitive ( n = 4). Among the later, two were urology related [ 59 , 77 ], one involved MSM [ 48 ] and one intervention specifically introduced a form of monetary incentives for men [ 33 ]. Only one intervention was gender transformative [ 30 ] [ 30 , 32 , 33 , 48 , 49 , 53 , 55 , 58 , 59 , 61 , 77 ] Community-based health services ( n = 8) Health services provided included community-based TB diagnosis, HIV testing, care, and treatment and comprehensive SRH.…”

“…Among the later, two were urology related [ 59 , 77 ], one involved MSM [ 48 ] and one intervention specifically introduced a form of monetary incentives for men [ 33 ]. Only one intervention was gender transformative [ 30 ] [ 30 , 32 , 33 , 48 , 49 , 53 , 55 , 58 , 59 , 61 , 77 ] Community-based health services ( n = 8) Health services provided included community-based TB diagnosis, HIV testing, care, and treatment and comprehensive SRH. Few other interventions were church based [ 73 , 84 ] Gender norms of traditional masculinity (bodily resilience, self-reliance, and control) and the perceived stigma relating to specific health conditions such as HIV or TB were described as main intersecting barriers for men to seek help for their health.…”

“…Marginal Man, in a paradox (n = 9; 16%) This conceptualisation described men as occupying a paradoxical or ambiguous position: their engagement was recognised as key for programmes’ success and disease control, but because of structural barriers limiting their access to, and uptake of services, they were often overlooked in program and health system design. This conceptualisation was predominant among papers that studied minority groups of men such as MSM [ 41 , 48 , 57 , 69 , 79 ]. Studying the role of gender in men’s health seeking for HIV and TB, Chikovore and colleagues noted, for example: “Despite men’s key role in TB transmission dynamics, relatively limited emphasis has been put on their epidemiological or social positions.…”

Stigmatization of men who have sex with men in health care settings in East Africa is based more on perceived gender role-inappropriate mannerisms than having sex with men

“…Men were contacted and recruited through peer educator links with key populations, social media [13], phone call appointments, CBO databases, MSM networks and organizations working with MSM/gay men, CBO organizers, and snowball contacts. We previously characterized social networks in MSM in two cities in Tanzania and have demonstrated that there are clearly established social networks in Dar es Salaam, the major metropolitan area, and a smaller provincial city [14].…”