Abstract:
Globally, gay men and other men who have sex with men are 19 times more likely to be living with HIV than the general population. The prevalence of HIV/AIDS among Men who have sex with men in Nairobi has been reported to be 18.2% which is a public health concern. This study determined factors affecting uptake of HIV/AIDS prevention services among MSM in Nairobi County. This was a cross sectional study that utilized mixed method of data collection. Study population included MSM (n=380), 6 managers who were in-charge of HIV/AIDS programmes in Public and Private Health facilities and Directors in charge of non-governmental organizations that supported MSM health needs. Participants were recruited through snowballing and purposive sampling respectively. Quantitative data was collected through a developed self administered questionnaire while qualitative data was collected through in-depth interviews. Uptake of HIV/AIDS testing as predicted by Pre and Post HIV counseling is 52.80%, other STI testing is reported at 31% and always use of condom is reported to be 22%. Being a student, a sex worker, and unmarried are predictors of HIV/AIDS prevention services uptake. Majority of MSM reported that TB drugs (70.1/%), antiretroviral drugs (71.6%), lubricants (79.5%), condoms (84.5%), and other STI treatment services (76.8%) were accessible. Barriers to HIV/AIDS prevention included personal negative attitudes, discrimination (31.6%) and stigma (26.3%) encountered at facility level. Alcohol and illicit drug consumption adversely affected health seeking as alcohol and drug usage accounted for 48.4% and 48.5% respectively. MSM specific health packages and policy guidelines are lacking and there is over reliance on donor funding for MSM health support. In conclusion, uptake of HIV/AIDS prevention services was low. Discrimination and stigma adversely affected HIV/AIDS health seeking practices by MSM, mostly encountered at the facility level. MSM engaged in alcohol and substance use that likely affected HIV/AIDS health seeking behaviour. MSM also engaged in risky behaviours that could negate the HIV/AIDS prevention efforts in Nairobi County. It is recommended that a policy on MSM health should be drawn. There is need for healthcare workers at facility level to be trained on MSM specific health needs.
