Men who have sex with men sensitivity training reduces homoprejudice and increases knowledge among Kenyan healthcare providers in coastal Kenya

Abstract

IntroductionHealthcare workers (HCWs) in Africa typically receive little or no training in the healthcare needs of men who have sex with men (MSM), limiting the effectiveness and reach of population-based HIV control measures among this group. We assessed the effect of a web-based, self-directed sensitivity training on MSM for HCWs (www.marps-africa.org), combined with facilitated group discussions on knowledge and homophobic attitudes among HCWs in four districts of coastal Kenya.MethodsWe trained four district “AIDS coordinators” to provide a two-day training to local HCWs working at antiretroviral therapy-providing facilities in coastal Kenya. Self-directed learning supported by group discussions focused on MSM sexual risk practices, HIV prevention and healthcare needs. Knowledge was assessed prior to training, immediately after training and three months after training. The Homophobia Scale assessed homophobic attitudes and was measured before and three months after training.ResultsSeventy-four HCWs (68% female; 74% clinical officers or nurses; 84% working in government facilities) from 49 health facilities were trained, of whom 71 (96%) completed all measures. At baseline, few HCWs reported any prior training on MSM anal sexual practices, and most HCWs had limited knowledge of MSM sexual health needs. Homophobic attitudes were most pronounced among HCWs who were male, under 30 years of age, and working in clinical roles or government facilities. Three months after training, more HCWs had adequate knowledge compared to baseline (49% vs. 13%, McNemar's test p<0.001); this was most pronounced in those with clinical or administrative roles and in those from governmental health providers. Compared to baseline, homophobic attitudes had decreased significantly three months after training, particularly among HCWs with high homophobia scores at baseline, and there was some evidence of correlation between improvements in knowledge and reduction in homophobic sentiment.ConclusionsScaling up MSM sensitivity training for African HCWs is likely to be a timely, effective and practical means to improve relevant sexual health knowledge and reduce personal homophobic sentiment among HCWs involved in HIV prevention, testing and care in sub-Saharan Africa.

The epidemiology of HIV and prevention needs among men who have sex with men in Africa

“…First, due to the nature of qualitative methodology, participants’ responses might be influenced by social desirability and peer influences. Second, the findings reported here do not permit temporal, causal, or quantitative inferences, but indeed correspond with programme evaluation data reported in a related paper [14]. Third, due to the voluntary nature of participation, attitudes expressed by HCWs in this sample might not be representative of their peers and colleagues.…”

Women Who Have Sex with Women in Kenya and Their Sexual and Reproductive Health

“…To date, available public health literature on gays and lesbians in Kenya has focused exclusively on men who have sex with men (MSM) to the exclusion of WSW. [1][2][3][4][5][6][7] Data on HIV and sexually transmitted infection (STI) transmission in Kenya have included only MSM and heterosexuals. [8][9][10] Lack of research on WSW in comparison to heterosexual men and women, as well as MSM, in general, can be attributed to perceived lower-risk of HIV infection or STIs among WSW.…”

(Des)preparo técnico-científico para o cuidado às travestis: percepções de enfermeiras(os)

“…20 Talvez, um primeiro passo, seja repensar a formação dos profissionais que atendem as travestis. Os profissionais da saúde, cada vez mais, precisam estar aptos para atuar na problematização de temas como sexualidade, gênero e diversidade nos diferentes cenários de assistência, a fim de facilitar o atendimento adequado para as travestis, minimizando as situações de violência, tais como as citadas ao longo deste trabalho.…”